title: Mortality in British hip fracture patients, 2000-2010: a population-based retrospective cohort study.
abstract: BACKGROUND
  Data on recent trends in mortality after hip fracture are scarce. Aims were therefore to examine secular trends in all-cause and cause-specific mortality post hip fracture and to compare this to the general population from 2000 to 2010.
  
  
  METHODS
  Population-based cohort study within the United Kingdom Clinical Practice Research Datalink and linked to cause of death data for 57.7% of patients. Patients with a first hip fracture (n=31,495) were matched to up to four controls by age, sex, index date, and practice. All subjects were followed for death, and lifestyle, disease and medication history adjusted hazard ratios (HRs) were calculated.
  
  
  RESULTS
  One-year all-cause mortality after hip fracture declined from 2009 and was 14% lower after, compared with before 2009 (22.3% to 20.5%, adj. HR 0.86, 95% CI: 0.81-0.92). The decline was observed for males (≥75years) and females (≥85years). Significant contributors to the decline in mortality post hip fracture were respiratory infections in females as were malignant diseases in males. However, one-year all-cause mortality remained unaltered over the decade when compared to controls with a 3.5-fold and 2.4-fold increased risk in males and females respectively. No significant changes were observed in the relative risks for one-year cause-specific mortality for both genders.
  
  
  CONCLUSIONS
  One-year mortality after hip fracture has declined over the last decade in the UK. However, the difference in one-year mortality between hip fracture patients and the general population remained unaltered. These observations highlight the need for the continued implementation of evidence-based standards for good hip fracture care.
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, Netherlands.
authors.forename: Corinne
authors.initials: C
authors.lastname: Klop
authors.affiliation: Rheumatology and Clinical Immunology, University Medical Center Utrecht, 3508 GA Utrecht, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center, 3508 GA Utrecht, Netherlands.
authors.forename: Paco M J
authors.initials: PM
authors.lastname: Welsing
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, United Kingdom; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford OX3 7HE, United Kingdom.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, United Kingdom; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, NHS Foundation Trust, Southampton, United Kingdom.
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Harvey
authors.affiliation: Department of General Practice and Elderly Care, VU University Medical Center, 1081 BH Amsterdam, Netherlands.
authors.forename: Petra J M
authors.initials: PJ
authors.lastname: Elders
authors.affiliation: Rheumatology and Clinical Immunology, University Medical Center Utrecht, 3508 GA Utrecht, Netherlands.
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, Netherlands.
authors.forename: Hubert G M
authors.initials: HG
authors.lastname: Leufkens
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, Netherlands; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, United Kingdom; Maastricht University Medical Center, Department of Clinical Pharmacy and Toxicology, 6202 AZ Maastricht, Netherlands; Maastricht University/CAPHRI, 6200 MD Maastricht, Netherlands. Electronic address: f.devries@uu.nl.
authors.forename: Frank
authors.initials: F
authors.lastname: de Vries
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000401:mortality*; D006801:Humans; D008297:Male; D011336:Probability; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Epidemiology; Hip fracture; Mortality; Osteoporosis; Osteoporotic fracture