title: Trends in mortality following hip fracture in older women.
abstract: OBJECTIVE
  To examine contemporary trends in mortality following hip fracture among older postmenopausal women in an integrated healthcare delivery system.
  
  
  METHODS
  Retrospective cohort study of 13,550 women aged ≥65 years with hip fracture during 2000 to 2010.
  
  
  METHODS
  Demographic factors, comorbidity index score, fracture history, early rehospitalization, and all-cause mortality within 1 year following hip fracture were examined using health plan databases and records. Temporal trends, risk factors, and the association of race/ethnicity and mortality within 1 year post fracture were examined using multivariable logistic regression.
  
  
  RESULTS
  Among 13,550 women with hip fracture, 84.6% were aged ≥75 years: 83.6% were white, 2.8% black, 5.6% Hispanic, 4.5% Asian, and 3.5% of other/unknown race. Following hip fracture, 2.4% died during the index hospitalization, while 12.3% were rehospitalized within 30 days of discharge. Infection, pneumonia, and cardiovascular conditions were the most common nonorthopedic indications for readmission. Mortality rates at 6 months (17%) and 1 year (22.8%) following hip fracture were high and increased with age. Greater comorbidity and early rehospitalization were associated with increased mortality risk, while Asian and Hispanic race/ethnicity were associated with lower mortality risk (vs white). Temporal trends demonstrated a small but significant reduction in mortality risk during 2004 to 2010.
  
  
  CONCLUSIONS
  While hip fracture morbidity and mortality remain high, temporal trends suggest recent declines in mortality risk, with risk of death following hip fracture lower for Asian and Hispanic women. Future studies should examine potential benefits of targeted interventions within integrated healthcare settings and factors contributing to observed racial/ethnic differences in post fracture survival.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Lo
authors.forename: Sowmya
authors.initials: S
authors.lastname: Srinivasan
authors.forename: Malini
authors.initials: M
authors.lastname: Chandra
authors.forename: Mary
authors.initials: M
authors.lastname: Patton
authors.forename: Amer
authors.initials: A
authors.lastname: Budayr
authors.forename: Lucy H
authors.initials: LH
authors.lastname: Liu
authors.forename: Gene
authors.initials: G
authors.lastname: Lau
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Grimsrud
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006620:Hip Fractures / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D010359:Patient Readmission / Q000706:statistics & numerical data; D044469:Racial Groups; D012189:Retrospective Studies