Background/Purpose:

The mortality of the fragility hip fracture patients has been reported to be higher compared to the general population for both men and women, and higher in men than in women. The highest incidence of fragility hip fracture has been reported from Norway. Our aim was to study mortality rates in patients with fragility hip fracture in Southern Norway after 1 and 5 years and compare them with the general background population.

Methods:

The hip fracture patients were identified in the two most southern counties in Norway, Vest-Agder and Aust-Agder County. Six percent of the Norwegian population (4.9 million) lives in this geographic area. Individuals over 50 years resident in the two counties who had a fragility hip fracture between 1 January 2004 and 31 December 2005 were included. The hospital electronic diagnosis registers were used to identify all hip fracture patients in the two year period coded as S72.0-2 according to the International Classification of Diseases 10th Revision (ICD-10). Data on age, gender, date of hip fracture and death date up to five years after the fracture date were collected in all patients. The follow-up time for one person was from the month the fracture occurred to death or the censoring date in January 1, 2009 and 2010. For each fracture patient 3 age and gender matched controls from the same geographic area was randomly selected from Norway’s national register. Standardized mortality ratio (SMR) was calculated comparing with mortality rates in the Norwegian population using the SPSS version 17.0 (SPSS, Chicago, IL, USA).  Statistical significance was defined as p<0.05.

Results:

In the two year period, the final number of fragility hip fractures in the geographic area was 951 (271 men and 680 women). Mean age for all included patients was 81.2 years (men 80.0 years and women 81.8 years). The SMR for men and women compared to the Norwegian population for the 1^st year was 2.78 (95% CI 2.24-3.31) and 2.08 (95% CI 1.77-2.38) and after 5 years 3.10 (95% CI 2.21-3.98) and 1.82 (95% CI 1.41-2.22) respectively. The overall mortality rates for patients with a fragility hip fracture older than 80 years at the end of 1^st year were 29.4% (44.6% for men and 24.0% for women, p<0.005) and at the end of 5^thyear 69.2% (85.4% for men and 63.5% for women, p<0.005). The mortality rates in patients with a fragility hip fracture after one year were higher in men than in women (men 32.1% and women 19.0%, p<0.005). The corresponding figures for the controls were 6.5% for men and 5.0% for women (p<0.1). After 5 years the mortality rate was 69.9% for men and 54.3% for women (p<0.005) with a fragility hip fracture and for the controls 24.0 % for men and 21.5 % for women (p<0.1).

Conclusion:

Mortality rates in patients with a fragility hip fracture are elevated compared to matched controls and the background population at the first year and continues to be elevated after 5 years, especially in men. Future research should focus on identifying risk factors for this increased mortality in hip fracture patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/mortality-after-fragility-hip-fracture-in-middle-aged-and-elderly-men-and-women-in-southern-norway/