title: Mortality after hip fracture in Austria 2008-2011.
abstract: Osteoporosis-related hip fractures represent a substantial cause of mortality and morbidity in industrialized countries like Austria. Identification of groups at high risk for mortality after hip fracture is crucial for health policy decisions. To determine in-hospital, long-term, and excess mortality after osteoporosis-related hip fracture in Austrian patients, we conducted a retrospective cohort analysis of pseudonymized invoice data from Austrian social insurance authorities covering roughly 98 % of the entire population. The data set included 31,668 subjects aged 50 years and above sustaining a hip fracture between July 2008 and December 2010 with follow-up until June 2011, and an age-, gender-, and regionally matched control population without hip fractures (56,320 subjects). Kaplan-Meier and Cox hazard regression analyses served to determine unadjusted and adjusted mortality rates: Unadjusted all-cause 1-year mortality amounted to 20.2 % (95 % CI: 19.7-20.7 %). Males had significantly higher long-term, in-hospital, and excess mortality rates than females, but younger males exhibited lower excess mortality than their female counterparts. Advanced age correlated with increased long-term and in-hospital mortality, but lower excess mortality. Excess mortality, particularly in males, was highest in the first 6 months after hip fracture, but remained statistically significantly elevated throughout the observation period of 3 years. Longer hospital stay per fracture was correlated with mortality reduction in older patients and in patients with more subsequent fractures. In conclusion, more efforts are needed to identify causes and effectively prevent excess mortality especially in male osteoporosis patients.
authors.affiliation: Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of the WGKK and AUVA Trauma Center, 1st Medical Department at Hanusch Hospital, Heinrich Collin Str. 30, 1140, Vienna, Austria, wolfgang.brozek@osteologie.at.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Brozek
authors.forename: Berthold
authors.initials: B
authors.lastname: Reichardt
authors.forename: Oliver
authors.initials: O
authors.lastname: Kimberger
authors.forename: Jochen
authors.initials: J
authors.lastname: Zwerina
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Dimai
authors.forename: Daniela
authors.initials: D
authors.lastname: Kritsch
authors.forename: Klaus
authors.initials: K
authors.lastname: Klaushofer
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Zwettler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000401:mortality; D058866:Osteoporotic Fractures / Q000401:mortality*; D016016:Proportional Hazards Models; D012189:Retrospective Studies