title: Mortality following the first hip fracture in Norwegian women and men (1999-2008). A NOREPOS study.
abstract: Hip fractures are associated with increased mortality and their incidence in Norway is one of the highest worldwide. The aim of this nationwide study was to examine short- and long-term mortality after hip fractures, burden of disease (attributable fraction and potential years of life lost), and time trends in mortality compared to the total Norwegian population. Information on incident hip fractures between 1999 and 2008 in all persons aged 50 years and older was collected from Norwegian hospitals. Death and emigration dates of the hip fracture patients were obtained through 31 December 2010. Standardized mortality ratios (SMRs) were calculated and Poisson regression analyses were used for the estimation of time trends in SMRs. Among the 81,867 patients with a first hip fracture, the 1-year excess mortality was 4.6-fold higher in men, and 2.8-fold higher in women compared to the general population. Although the highest excess mortality was observed during the first two weeks post fracture, the excess risk persisted for twelve years. Mortality rates post hip fracture were higher in men compared to women in all age groups studied. In both genders aged 50 years and older, approximately 5% of the total mortality in the population was related to hip fractures. The largest proportion of the potential life-years lost was in the relatively young-old, i.e. less than 80 years. In men, the 1-year absolute mortality rates post hip fracture declined significantly between 1999 and 2008, by contrast, the mortality in women increased significantly relatively to the population mortality.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway; Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway; Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway. Electronic address: t.k.omsland@medisin.uio.no.
authors.forename: Tone K
authors.initials: TK
authors.lastname: Omsland
authors.affiliation: Department of Health and Care Sciences, University of Tromsø, Norway.
authors.forename: Nina
authors.initials: N
authors.lastname: Emaus
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.
authors.forename: Grethe S
authors.initials: GS
authors.lastname: Tell
authors.affiliation: Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway.
authors.forename: Jeanette H
authors.initials: JH
authors.lastname: Magnus
authors.affiliation: Department of Health and Care Sciences, University of Tromsø, Norway.
authors.forename: Luai Awad
authors.initials: LA
authors.lastname: Ahmed
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway; Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Holvik
authors.affiliation: Osteoporosis and Bone Biology Program, Garvan Institute of Medical Research, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Center
authors.affiliation: Institute of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: Siri
authors.initials: S
authors.lastname: Forsmo
authors.affiliation: Department of Rheumatology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Norway.
authors.forename: Clara G
authors.initials: CG
authors.lastname: Gjesdal
authors.affiliation: Institute of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Obstetrics and Gynecology, St. Olav's University Hospital, Trondheim, Norway.
authors.forename: Berit
authors.initials: B
authors.lastname: Schei
authors.affiliation: Clinical Institute, Aalborg University, Aalborg, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Vestergaard
authors.affiliation: Osteoporosis and Bone Biology Program, Garvan Institute of Medical Research, Sydney, NSW, Australia; Clinical Translation and Advanced Education, Garvan Institute of Medical Research, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia.
authors.forename: John A
authors.initials: JA
authors.lastname: Eisman
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Falch
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Aage
authors.initials: A
authors.lastname: Tverdal
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Anne Johanne
authors.initials: AJ
authors.lastname: Søgaard
authors.affiliation: Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway; Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Haakon E
authors.initials: HE
authors.lastname: Meyer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012044:Regression Analysis; D012737:Sex Factors
keywords: Attributable risk; Burden of disease; Gender differences; Hip fracture; Mortality