Has mortality after a hip fracture increased?
OBJECTIVE
To study changes in mortality and causes of death in patients suffering a hip fracture between 1981 and 2001.


METHODS
Historic, register-based cohort study.


METHODS
Nationwide cohort study in Denmark.


METHODS
All 163,313 patients suffering a hip fracture between 1981 and 2001 in Denmark and 505,960 age- and sex-matched controls.


METHODS
Osteosynthesis, arthroplasty, or other management for the hip fracture.


METHODS
Mortality and cause of death at 30 days and 1 year.


RESULTS
The mean age of the patients with hip fracture increased (from 75.8 in 1981 to 78.1 in 2001, P<.01), and the proportion of men with hip fracture also increased (from 25.5% to 29.8%, P<.01). A statistically significant decrease was observed in crude 1-year survival. Mortality increased in subjects with a hip fracture from 1981/85 to 1986/2001, whereas it decreased among controls. There was significantly greater mortality in patients undergoing arthroplasty (relative risk=1.05, 95% confidence interval=1.03-1.07) than in those undergoing osteosynthesis. Causes of death related to the trauma that caused the fracture explained most of the deaths (68-76%) within the first 30 days after the fracture.


CONCLUSIONS
Significant demographic changes took place, with older people and more men experiencing hip fracture. After adjustment for age, sex, and comorbidity, survival was poorer in patients suffering a hip fracture than in controls. This calls for measures to improve survival.
Vestergaard
Peter
P
Department of Endocrinology and Metabolism C, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark. vest@post4.tele.dk
Rejnmark
Lars
L
Mosekilde
Leif
L
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality; D002423:Cause of Death / Q000639:trends*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D005264:Femoral Fractures / Q000401:mortality / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000401:mortality; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D012016:Reference Values; D012042:Registries; D012737:Sex Factors; D016019:Survival Analysis