title: Risk factors and predictors of mortality for proximal humeral fractures.
abstract: BACKGROUND
  Risk factors for mortality after proximal humeral fracture, including socioeconomic status, are poorly defined. This retrospective review of prospectively collected data defines the epidemiology and predictors of mortality in association with proximal humeral fractures.
  
  
  METHODS
  Patients who sustained proximal humeral fractures were identified from fragility fracture and trauma databases between May 2001 and September 2012.
  
  
  RESULTS
  In total, 1880 patients with a mean age of 69 years and a male to female ratio of 2 : 3 were identified. Socioeconomic distribution is skewed towards the lowest and highest quintiles. Low-energy mechanisms caused 88% of fractures. Men sustain fractures when they are aged 10 years younger and via higher-energy mechanisms. In total, 536 patients (29%) died within the study period with a 1-year mortality of 9.8%, rising to 28.2% at 5 years. Female gender, increasing age, pathological fracture and increased number of co-morbidities were independent variables for increased mortality.
  
  
  CONCLUSIONS
  The present study, which was conducted over an 11-year period, is the first to combine the epidemiology and risk factors for mortality with socioeconomic rank. One-year mortality risk is twice that of the background matched population. Patient counselling with respect to increased mortality should be considered, especially in higher-risk elderly females with multiple co-morbidities.
authors: Nottingham Shoulder and Elbow Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors: Lyndsay A
authors: LA
authors: Wilson
authors: Nottingham Shoulder and Elbow Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors: Benjamin Wt
authors: BW
authors: Gooding
authors: Nottingham Shoulder and Elbow Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors: Paul A
authors: PA
authors: Manning
authors: Nottingham Shoulder and Elbow Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors: W Angus
authors: WA
authors: Wallace
authors: Nottingham Shoulder and Elbow Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors: John M
authors: JM
authors: Geoghegan
keywords: Co-morbidities; epidemiology; fracture; humeral; humerus; mortality; proximal; risk factors