title: Mortality and complications of hip fracture in young adults: a nationwide population-based cohort study.
abstract: BACKGROUND
  This study assessed the mortality and complications of hip fractures using in-patients aged 20-40 years from a nationwide population database in Taiwan.
  
  
  METHODS
  Subjects were selected from Taiwan's National Health Insurance Research Database for the period 2000-2008, and these subjects were followed up until the end of 2010. A total of 5,079 (3,879 male and 1,200 female) subjects were admitted for the first time with primary diagnosis of hip fracture and treated with operation. We calculated the long-term overall survival rate and complication-free rate. We also assessed the risk factors for mortality and complications.
  
  
  RESULTS
  The 1-month, 3-month, 6-month, 1-year, 2-year, 5-year, and 10-year complication-free rates were 98.3%, 96.2%, 94.5%, 86.8%, 80.4%, 75.3%, and 73.5% for the entire cohort, respectively. The 10-year survival rates were 93.3%, 91.8%, and 94.5% for total cases, trochanteric fracture, and cervical fracture, respectively. The 10-year complication-free rates were 73.5%, 80.5%, and 67.3% for total cases, trochanteric fracture, and cervical fracture, respectively. The risk factors for overall death were male, older age, and greater number of Charlson comorbidity index (CCI) comorbidities. The risk factors for complication were cervical fracture, and greater number of CCI comorbidities. Complications resulted in 42.83% of patients receiving internal fixation implants or prothesis removal and 2.01% underwent conversion to revision arthroplasty during follow-up.
  
  
  CONCLUSIONS
  The overall 10-year survival rate in hip fracture patients aged 20-40 years in Taiwan was over 90%. The 10-year complication-free rates were around 70%. Preventing the occurrence of severe complications after hip fracture among young adults is an important public health issue that warrants greater attention.
authors.affiliation: Department of Statistics, National Taipei University, Taipei 10478, Taiwan. cflin.ntpu@gmail.com.
authors.forename: Jeff Chien-Fu
authors.initials: JC
authors.lastname: Lin
authors.forename: Cheng-Chun
authors.initials: CC
authors.lastname: Wu
authors.forename: Chi
authors.initials: C
authors.lastname: Lo
authors.forename: Wen-Miin
authors.initials: WM
authors.lastname: Liang
authors.forename: Chi-Fung
authors.initials: CF
authors.lastname: Cheng
authors.forename: Chang-Bi
authors.initials: CB
authors.lastname: Wang
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Chang
authors.forename: Hsi-Chin
authors.initials: HC
authors.lastname: Wu
authors.forename: Tsai-Hsueh
authors.initials: TH
authors.lastname: Leu
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000009:adverse effects; D015897:Comorbidity; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult