title: Excess mortality after hip fracture among the elderly in Taiwan: a nationwide population-based cohort study.
abstract: Osteoporotic hip fractures cause high mortality in the elderly population. However, few population studies reported the long-term mortality of hip fracture among the elderly in Asian population. This study assessed the incidence, excess mortality, and risk factors after osteoporotic hip fractures through inpatients aged 60 years or older. A total of 143,595 patients with hip fracture were selected from Taiwan National Health Insurance database in the years 1999 to 2009 and followed up until the end of 2010. Annual incidence, mortality and SMR, and mortality and SMR at different periods after fracture were measured. From 1999 to 2005, hip fracture incidence gradually increased and then fluctuated after 2006. From 1999 to 2009, the male-to-female ratio of annual incidence increased from 0.60 to 0.66, annual mortality for hip fracture decreased from 18.10% to 13.98%, male-to-female ratio of annual mortality increased from 1.38 to 1.64, and annual SMR decreased from 13.80 to 2.98. Follow-up SMR at one, two, five, and ten years post-fracture was 9.67, 5.28, 3.31, and 2.89, respectively. Females had higher follow-up SMR in the younger age groups (60-69 yr of age) but lower follow-up SMR in the older age groups (over 80 yr of age) compared with males. Among the studied patients, incidence is gradually decreasing along with annual mortality and SMR. Hip fracture affects short-term but not long-term mortality.
authors.affiliation: Graduate Institute of Public Health, China Medical University, Taichung 40402, Taiwan. cbwang.cmu@gmail.com
authors.forename: Chang-Bi
authors.initials: CB
authors.lastname: Wang
authors.forename: Chien-Fu Jeff
authors.initials: CF
authors.lastname: Lin
authors.forename: Wen-Miin
authors.initials: WM
authors.lastname: Liang
authors.forename: Chi-Fung
authors.initials: CF
authors.lastname: Cheng
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Chang
authors.forename: Hsi-Chin
authors.initials: HC
authors.lastname: Wu
authors.forename: Trong-Neng
authors.initials: TN
authors.lastname: Wu
authors.forename: Tsai-Hsueh
authors.initials: TH
authors.lastname: Leu
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology
keywords: Hip fracture; Mortality; Osteoporosis; Standardized mortality ratio