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Hip fracture and increased short-term but not long-term mortality in healthy older women

LeBlanc, ES and Hillier, TA and Pedula, KL and Rizzo, JH and Cawthon, PM and Fink, HA and Cauley, JA and Bauer, DC and Black, DM and Cummings, SR and Browner, WS (2011) Hip fracture and increased short-term but not long-term mortality in healthy older women. Archives of Internal Medicine, 171 (20). 1831 - 1837. ISSN 0003-9926

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Abstract

Background: Fractures have been associated with subsequent increases in mortality, but it is unknown how long that increase persists. Methods: A total of 5580 women from a large community- based, multicenter US prospective cohort of 9704 (Study of Osteoporotic Fractures) were observed prospectively for almost 20 years. We age-matched 1116 hip fracture cases with 4 control participants (n=4464). To examine the effect of health status, we examined a healthy older subset (n=960) 80 years or older who attended the 10-year follow-up examination and reported good or excellent health. Incident hip fractures were adjudicated from radiology reports by study physicians. Death was confirmed by death certificates. Results: Hip fracture cases had 2-fold increased mortality in the year after fracture compared with controls (16.9% vs 8.4%; multivariable adjusted odds ratio [OR], 2.4; 95% CI, 1.9-3.1]. When examined by age and health status, short-term mortality was increased in those aged 65 to 69 years (16.3% vs 3.7%; OR, 5.0; 95% CI, 2.6- 9.5), 70 to 79 years (16.5% vs 8.9%; OR, 2.4; 95% CI, 1.8-3.3), and only in those 80 years or older with good or excellent health (15.1% vs 7.2%; multivariable adjusted OR, 2.8; 95% CI, 1.5-5.2). After the first year, survival of hip fracture cases and controls was similar except in those aged 65 to 69 years, who continued to have increased mortality. Conclusions: Short-term mortality is increased after hip fracture in women aged 65 to 79 years and in exceptionally healthy women 80 years or older. Women 70 years or older return to previous risk levels after a year. Interventions are needed to decrease mortality in the year after hip fracture, when mortality risk is highest. ©2011 American Medical Association. All rights reserved.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
LeBlanc, ES
Hillier, TA
Pedula, KL
Rizzo, JH
Cawthon, PM
Fink, HA
Cauley, JAJCauley@edc.pitt.eduJCAULEY
Bauer, DC
Black, DM
Cummings, SR
Browner, WS
Date: 14 November 2011
Date Type: Publication
Journal or Publication Title: Archives of Internal Medicine
Volume: 171
Number: 20
Page Range: 1831 - 1837
DOI or Unique Handle: 10.1001/archinternmed.2011.447
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 0003-9926
Date Deposited: 03 Apr 2015 16:29
Last Modified: 04 Feb 2019 20:55
URI: http://d-scholarship.pitt.edu/id/eprint/24228

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