Persistence of Excess Mortality Following Individual Nonhip Fractures: A Relative Survival Analysis

Tran, T; Bliuc, D; Hansen, L; Abrahamsen, B; Van Den Bergh, J; Eisman, JA; Van Geel, T; Geusens, P; Vestergaard, P; Nguyen, TV; Center, JR

Persistence of Excess Mortality Following Individual Nonhip Fractures: A Relative Survival Analysis

Tran, T Bliuc, D Hansen, L Abrahamsen, B Van Den Bergh, J Eisman, JA Van Geel, T Geusens, P Vestergaard, P Nguyen, TV

Center, JR

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Publication Type:: Journal Article
Citation:: Journal of Clinical Endocrinology and Metabolism, 2018, 103 (9), pp. 3205 - 3214
Issue Date:: 2018-09-01

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Field	Value	Language
dc.contributor.author	Tran, T	en_US
dc.contributor.author	Bliuc, D	en_US
dc.contributor.author	Hansen, L	en_US
dc.contributor.author	Abrahamsen, B	en_US
dc.contributor.author	Van Den Bergh, J	en_US
dc.contributor.author	Eisman, JA	en_US
dc.contributor.author	Van Geel, T	en_US
dc.contributor.author	Geusens, P	en_US
dc.contributor.author	Vestergaard, P	en_US
dc.contributor.author	Nguyen, TV https://orcid.org/0000-0002-3246-6281	en_US
dc.contributor.author	Center, JR	en_US
dc.date.available	2018-05-11	en_US
dc.date.issued	2018-09-01	en_US
dc.identifier.citation	Journal of Clinical Endocrinology and Metabolism, 2018, 103 (9), pp. 3205 - 3214	en_US
dc.identifier.issn	0021-972X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/132477
dc.description.abstract	© 2018 Endocrine Society. Context: Little is known about long-term excess mortality following fragility nonhip fractures. Objective: The study aimed to determine which fracture was associated with excess mortality and for how long the postfracture excess mortality persisted. Design, Setting, and Patients: This nationwide registry-based follow-up study included all individuals in Denmark aged 50+ years who first experienced fragility fractures in 2001 and were followed up for up to 10 years for their mortality risk. Main Outcome Measure: The contribution of fracture to mortality at precise postfracture time intervals was examined using relative survival analysis, accounting for time-related mortality changes in the background population. Results: There were 21,123 women (aged 72 ± 13 years) and 9481 men (aged 67 ± 12 years) with an incident fragility fracture in 2001, followed by 10,668 and 4745 deaths, respectively. Excess mortality was observed following all proximal and lower leg fractures. The majority of deaths occurred within the first year after fracture, and thereafter excess mortality gradually declined. Hip fractures were associated with the highest excess mortality (33% and 20% at 1 year after fracture in men and women, respectively). One-year excess mortality after fracture of a femur or pelvis was 20% to 25%; vertebrae, 10%; humerus, rib, or clavicle, 5% to 10%; and lower leg, 3%. A significant although smaller excess mortality was still observed until 10 years for hip fractures and ∼5 years after femur, other proximal, and lower leg fractures. Conclusion: This study highlights the important contribution of a wide variety of fragility fractures to long-term excess mortality and thus the potential for benefit from early intervention.	en_US
dc.relation.ispartof	Journal of Clinical Endocrinology and Metabolism	en_US
dc.relation.isbasedon	10.1210/jc.2017-02656	en_US
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject.classification	Endocrinology & Metabolism	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Femoral Fractures	en_US
dc.subject.mesh	Hip Fractures	en_US
dc.subject.mesh	Registries	en_US
dc.subject.mesh	Cause of Death	en_US
dc.subject.mesh	Survival Analysis	en_US
dc.subject.mesh	Follow-Up Studies	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Denmark	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Osteoporotic Fractures	en_US
dc.title	Persistence of Excess Mortality Following Individual Nonhip Fractures: A Relative Survival Analysis	en_US
dc.type	Journal Article
utslib.citation.volume	9	en_US
utslib.citation.volume	103	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	closed_access	*
pubs.issue	9	en_US
pubs.publication-status	Published	en_US
pubs.volume	103	en_US

Abstract:

© 2018 Endocrine Society. Context: Little is known about long-term excess mortality following fragility nonhip fractures. Objective: The study aimed to determine which fracture was associated with excess mortality and for how long the postfracture excess mortality persisted. Design, Setting, and Patients: This nationwide registry-based follow-up study included all individuals in Denmark aged 50+ years who first experienced fragility fractures in 2001 and were followed up for up to 10 years for their mortality risk. Main Outcome Measure: The contribution of fracture to mortality at precise postfracture time intervals was examined using relative survival analysis, accounting for time-related mortality changes in the background population. Results: There were 21,123 women (aged 72 ± 13 years) and 9481 men (aged 67 ± 12 years) with an incident fragility fracture in 2001, followed by 10,668 and 4745 deaths, respectively. Excess mortality was observed following all proximal and lower leg fractures. The majority of deaths occurred within the first year after fracture, and thereafter excess mortality gradually declined. Hip fractures were associated with the highest excess mortality (33% and 20% at 1 year after fracture in men and women, respectively). One-year excess mortality after fracture of a femur or pelvis was 20% to 25%; vertebrae, 10%; humerus, rib, or clavicle, 5% to 10%; and lower leg, 3%. A significant although smaller excess mortality was still observed until 10 years for hip fractures and ∼5 years after femur, other proximal, and lower leg fractures. Conclusion: This study highlights the important contribution of a wide variety of fragility fractures to long-term excess mortality and thus the potential for benefit from early intervention.

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http://hdl.handle.net/10453/132477