September 29, 2011

Hip Fractures Associated With Death Rates in Elderly Women

(Ivanhoe Newswire) — Hip fractures are associated with death within one year for women ages 65-79 years and healthy women ages 80 years and older. The risk returns to previous level after one year for women ages 70 and older, according to this study.

Nearly 300,000 hip fractures occur each year in the United States, causing substantial short- and long-term disability and increased mortality. Previous research to determine the mortality risk associated with hip fracture has not always accounted for differences in health status.

"Such methodological limitations have made it difficult to determine whether the noted increase in mortality after hip fracture is the result of underlying poor health or the hip fracture itself," the authors were quoted as saying. Additionally, studies that explored the influence of age on mortality after hip fracture have conflicting results. The researchers sought to determine the short-term (one year or less), intermediate-term (between one and five years) and long-term (between five and 10 years) mortality associated with hip fracture, as well as whether healthy women ages 80 years and older would have increased mortality associated with hip fracture when compared with healthy controls of the same age.

Erin S. LeBlanc, M.D., M.P.H., from the Center for Health Research, Kaiser Permanente Northwest, Portland, Ore., and colleagues prospectively studied participants in the Study of Osteoporotic Fractures. The researchers selected 1,116 women with hip fracture and matched each with four control participants of the same age who did not have hip fracture (n = 4,464) for a total of 5,580 participants. Through a healthy older subset (n = 960) of participants ages 80 years or older who attended a 10-year follow-up examination and reported good or excellent health, the researchers were able to examine the association with health status. The authors determined incident (new-onset) hip fractures by examining radiology reports, and used death certificates to confirm participant deaths.

For participants with hip fracture, the odds of death were twice as high in the year after the fracture as were controls (16.9 percent vs. 8.4 percent). The odds of short-term mortality increased in participants ages 65 to 70 years (16.3 percent vs. 3.7 percent) and 70 to 79 years (16.5 percent vs. 8.9 percent); an increase was also observed in women ages 80 years or older with good or excellent health (15.1 percent vs. 7.2 percent). After one year following fracture, participants with fracture and controls had similar mortality, except those with fracture ages 65 to 70 years who continued to have an increase in mortality.

"If our findings are replicated, they would suggest that research should focus on hip fracture prevention and interventions in these groups that could decrease mortality during that high-risk period," the authors explained. "Women who are 65 to 70 years of age continue to have an increased risk of mortality for up to five to 10 years; therefore, prevention of hip fractures in these women should be of high priority."

SOURCE: Archives of Internal Medicine, published online September 2011