title: Incidence and excess mortality of hip fracture in young adults: a nationwide population-based cohort study.
abstract: This study assessed the incidence and excess mortality of hip fractures among inpatients aged 20-40 years in a nationwide population database in Taiwan.
  
  
  
  Subjects were selected from Taiwan's National Health Insurance Research Database for the period 2001-2008 and were followed up until the end of 2010. A total of 4,523 subjects were admitted for the first time with primary diagnosis of hip fracture and treated with operation.
  
  
  
  The overall annual incidence, mortality, and standardized mortality ratio (SMR) decreased from 7.68 to 7.23 per 100,000, from 1.37 % to 0.94 %, and from 9.06 to 6.71, respectively, from 2001 to 2008. The 1-year, 2-year, 3-year, 5-year, and 10-year mortality rates were 1.28 %, 2.44 %, 3.54 %, 5.32 %, and 10.50 %, respectively for the whole cohort. The 1-year, 2-year, 3-year, 5-year, and 10-year SMRs were 8.33, 7.59, 7.28, 6.39, and 5.82, respectively, for the whole cohort. Risk factors for overall death were male gender, trochanteric fracture, hemiarthroplasty, and higher Charlson comorbidity index (CCI) scores.
  
  
  
  The high SMRs found in the present study suggest that young adults with former hip fracture should be closely followed up to prevent early mortality.
authors: Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Tsai-Hsueh
authors: TH
authors: Leu
authors: Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Wei-Chun
authors: WC
authors: Chang
authors: Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. cflin.ntpu@gmail.com.|Department of Statistics, National Taipei University, Taipei, Taiwan. cflin.ntpu@gmail.com.
authors: Jeff Chien-Fu
authors: JC
authors: Lin
authors: Department of Hospitality Management, Chung Hua University, Hsinchu, Taiwan. lochichilo@gmail.com.
authors: Chi
authors: C
authors: Lo
authors: Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan.|Department of Public Health, China Medical University, Taichung, Taiwan.
authors: Wen-Miin
authors: WM
authors: Liang
authors: Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan.
authors: Yu-Jun
authors: YJ
authors: Chang
authors: Department of Public Health, China Medical University, Taichung, Taiwan.|Healthcare System Operation Center, Changhua Christian Hospital, Changhua, Taiwan.
authors: Dann-Pyng
authors: DP
authors: Shih
authors: Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Cheng-Chun
authors: CC
authors: Wu
authors: Department of Public Health, China Medical University, Taichung, Taiwan.
authors: Chi-Fung
authors: CF
authors: Cheng
authors: Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan.
authors: Sy-Jye
authors: SJ
authors: Wei
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D062785:Hemiarthroplasty / Q000009:adverse effects*; D006620:Hip Fractures / Q000453:epidemiology* / Q000601:surgery*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology
keywords: Hip fracture; Incidence; Mortality; Nationwide population-based study; Standardized mortality ratio; Young adults