A long-term follow-up of 221 hip fracture patients in southeastern Finland: analysis of survival and prior or subsequent fractures.
To analyze the type and effect of prior and subsequent fractures in a hip fracture cohort.


METHODS
Hip fracture patients (n=221) were followed for a mean of 8 years and all prior and subsequent fractures were studied. Incidence of the first fracture and subsequent fractures according to sex, age group, and time between the first and the index hip fracture were measured. The absolute fracture risk was measured in the study subjects and in the age groups <75 years and ≥75 years. Patients' survival was analyzed with the life-table method.


RESULTS
One third of the hip fracture patients had sustained previous fractures. In men, these were mostly ankle or hip fractures, and in women, wrist fractures. Of the subjects, 24% suffered a subsequent fracture, which in both sexes was usually a second hip fracture. At the end of the 8-year follow-up, 74% of the patients had died. The observed absolute fracture risk was 7% at one year and 24% at 5 years. In women, excess mortality was lowest during the first 4.8 years after the index hip fracture among patients with one fracture. However, it was highest among women with two fractures. In men, excess mortality was lowest among those with two fractures and highest among those with ≥3 fractures. There were no differences between the genders in sustaining subsequent fractures.


CONCLUSIONS
The fracture risk subsequent to hip fracture was similar in both genders. Patients with prior hip fractures had the worst survival rate.
Department of Orthopaedics and Traumatology, North-Kymi Hospital, FI-45750 Kuusankoski, Finland. peter.luthje@pp.inet.fi
Peter
P
Lüthje
Teemu
T
Helkamaa
Juha-Pekka
JP
Kaukonen
Ilona
I
Nurmi-Lüthje
Matti
M
Kataja
D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D050723:Fractures, Bone / Q000453:epidemiology; D006620:Hip Fractures / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014954:Wrist Injuries / Q000453:epidemiology