title: A comparison of survival rates for hip fracture patients with or without subsequent osteoporotic vertebral compression fractures.
abstract: Little is known about the effect of a subsequent osteoporotic vertebral compression fracture on the survival rate of patients with a previous hip fracture.  In this study, we aimed to compare the survival rates of hip fracture patients with and without subsequent osteoporotic vertebral compression fractures and determine the risk factors associated with subsequent fracture.  During 2000-2008, 933 initial hip fracture patients were reviewed and divided into two groups: subsequent fracture group (160 patients) and single hip fracture group (i.e., no subsequent fracture; 773 patients).  All information pertaining to their most recent fracture event(s), including mortality causes/rates, were recorded.  Differences in mortality rates and hazard ratios (HRs) between the two groups were also analyzed.  The 1-year and 1-to-5-year mortality rates were 1.3% and 1.9%, respectively, in the subsequent fracture group, and 4.7% and 1.4%, respectively, in the single hip fracture group, with no significant differences observed.  Interestingly, the HR for mortality was significantly higher in the single hip fracture group than in the subsequent fracture group (p < 0.05).  The significant risk factors for subsequent fractures were identified as knee osteoarthritis, neurological disease, and an initial hip fracture with intertrochanteric involvement.  Our findings indicate that the occurrence of a vertebral compression fracture after an initial hip fracture does not greatly impact patient survival.  Conversely, patients presenting with a single hip fracture have a significantly higher mortality-HR, indicating that single hip fracture patients without subsequent fracture should be provided with the same standard of care as patients with subsequent fractures.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Thammasat University Pathum Thani, Thailand.
authors.forename: Chayanin
authors.initials: C
authors.lastname: Angthong
authors.forename: Wirana
authors.initials: W
authors.lastname: Angthong
authors.forename: Thos
authors.initials: T
authors.lastname: Harnroongroj
authors.forename: Thossart
authors.initials: T
authors.lastname: Harnroongroj
mesh_terms: D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D050815:Fractures, Compression / Q000453:epidemiology* / Q000473:pathology; D006620:Hip Fractures / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D016103:Spinal Fractures / Q000453:epidemiology* / Q000473:pathology; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors