title: Increased mortality after upper extremity fracture requiring inpatient care.
abstract: OBJECTIVE
  Increased mortality after hip fracture is well documented. The mortality after hospitalization for upper extremity fracture is unknown, even though these are common injuries. Here we determined mortality after hospitalization for upper extremity fracture in patients aged ≥16 years.
  
  
  METHODS
  We collected data about the diagnosis code (ICD10), procedure code (NOMESCO), and 7 additional characteristics of 5,985 patients admitted to the trauma ward of Central Finland Hospital between 2002 and 2008. During the study, 929 women and 753 men sustained an upper extremity fracture. The patients were followed up until the end of 2012. Mortality rates were calculated using data on the population at risk.
  
  
  RESULTS
  By the end of follow-up (mean duration 6 years), 179 women (19%) and 105 men (14%) had died. The standardized mortality ratio (SMR) for all patients was 1.5 (95% CI: 1.4-1.7). The SMR was higher for men (2.1, CI: 1.7-2.5) than for women (1.3, CI: 1.1-1.5) (p < 0.001). The SMR decreased with advancing age, and the mortality rate was highest for men with humerus fractures.
  
  
  CONCLUSIONS
  In men, the risk of death related to proximal humerus fracture was even higher than that reported previously for hip fracture. Compared to the general population, the SMR was double for humerus fracture patients, whereas wrist fracture had no effect on mortality.
authors.affiliation: a 1 Orthopaedics and Traumatology , University of Helsinki, Helsinki.
authors.forename: Axel
authors.initials: A
authors.lastname: Somersalo
authors.affiliation: b 2 Department of Orthopaedics and Traumatology , Central Finland Hospital, Jyväskylä
authors.forename: Juha
authors.initials: J
authors.lastname: Paloneva
authors.affiliation: c 3 Primary Health Care , Helsinki University Hospital, Helsinki.|d 4 Department of General Practice , University of Helsinki, Helsinki.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: e 5 Institute of Public Health and Clinical Nutrition, Department of Geriatrics , University of Eastern Finland, Kuopio.
authors.forename: Eija
authors.initials: E
authors.lastname: Lönnroos
authors.affiliation: f 6 Orthopaedics and Traumatology , University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Heinänen
authors.affiliation: f 6 Orthopaedics and Traumatology , University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Kiviranta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D050723:Fractures, Bone / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006810:Humeral Fractures / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012784:Shoulder Fractures / Q000401:mortality; D034941:Upper Extremity / Q000293:injuries*; D014954:Wrist Injuries / Q000401:mortality; D055815:Young Adult