Excess mortality attributable to hip-fracture: A relative survival analysis

Frost, SA; Nguyen, ND; Center, JR; Eisman, JA; Nguyen, TV

Excess mortality attributable to hip-fracture: A relative survival analysis

Frost, SA Nguyen, ND Center, JR Eisman, JA Nguyen, TV

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Publication Type:: Journal Article
Citation:: Bone, 2013, 56 (1), pp. 23 - 29
Issue Date:: 2013-09-01

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Field	Value	Language
dc.contributor.author	Frost, SA	en_US
dc.contributor.author	Nguyen, ND	en_US
dc.contributor.author	Center, JR	en_US
dc.contributor.author	Eisman, JA	en_US
dc.contributor.author	Nguyen, TV https://orcid.org/0000-0002-3246-6281	en_US
dc.date.available	2013-05-04	en_US
dc.date.issued	2013-09-01	en_US
dc.identifier.citation	Bone, 2013, 56 (1), pp. 23 - 29	en_US
dc.identifier.issn	8756-3282	en_US
dc.identifier.uri	http://hdl.handle.net/10453/28778
dc.description.abstract	Introduction: Individuals with hip fracture are at substantially increased risk of mortality. The aim of this study was to estimate the excess mortality attributable to hip fracture in elderly men and women. Methods: The Dubbo Osteoporosis Epidemiology Study was designed as a prospective epidemiologic investigation, in which more than 2000 men and women aged 60+ as of 1989 had been followed for 21. years. During the follow-up period, the incidence of atraumatic hip fractures was ascertained by X-ray reports, and mortality was ascertained by the New South Wales Birth, Death and Marriage Registry. Relative survival ratios were estimated by taking into account the age-and-sex specific expected survival in the general Australian population from 1989 to 2010. Results: During the follow-up period 151 women and 55 men sustained a hip fracture. Death occurred in 86 (57%) women and 36 (66%) men. In women, the cumulative relative survival post hip-fracture at 1, 5 and 10. years was 0.83 (95% confidence interval (CI) 0.76-0.89), 0.59 (95% CI 0.48-0.68), and 0.31 (95% CI 0.20-0.43), respectively; in men, the corresponding estimates of relative survival were: 0.63 (95% CI 0.48-0.75), 0.48 (95% CI 0.32-0.63), and 0.36 (95% CI 0.18-0.56). On average post hip-fracture women died 4. years earlier (median: 4.1, inter-quartile range (IQR) 1.7-7.8) and men died 5. years earlier (median. = 4.8, IQR 2.4-7.0) than expected. For every six women and for every three men with hip fracture one extra death occurred above that expected in the background population. Conclusion: Hip fracture is associated with reduced life expectancy, with men having a greater reduction than women, even after accounting for time-related changes in background mortality in the population. These data underscore that hip fracture is an independent clinical risk factor for mortality. © 2013 Elsevier Inc.	en_US
dc.relation.ispartof	Bone	en_US
dc.relation.isbasedon	10.1016/j.bone.2013.05.006	en_US
dc.subject.classification	Endocrinology & Metabolism	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hip Fractures	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Survival Analysis	en_US
dc.subject.mesh	Smoking	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	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Excess mortality attributable to hip-fracture: A relative survival analysis	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	56	en_US
utslib.for	110306 Endocrinology	en_US
utslib.for	0903 Biomedical Engineering	en_US
utslib.for	06 Biological Sciences	en_US
utslib.for	09 Engineering	en_US
utslib.for	11 Medical and Health Sciences	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	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	56	en_US

Abstract:

Introduction: Individuals with hip fracture are at substantially increased risk of mortality. The aim of this study was to estimate the excess mortality attributable to hip fracture in elderly men and women. Methods: The Dubbo Osteoporosis Epidemiology Study was designed as a prospective epidemiologic investigation, in which more than 2000 men and women aged 60+ as of 1989 had been followed for 21. years. During the follow-up period, the incidence of atraumatic hip fractures was ascertained by X-ray reports, and mortality was ascertained by the New South Wales Birth, Death and Marriage Registry. Relative survival ratios were estimated by taking into account the age-and-sex specific expected survival in the general Australian population from 1989 to 2010. Results: During the follow-up period 151 women and 55 men sustained a hip fracture. Death occurred in 86 (57%) women and 36 (66%) men. In women, the cumulative relative survival post hip-fracture at 1, 5 and 10. years was 0.83 (95% confidence interval (CI) 0.76-0.89), 0.59 (95% CI 0.48-0.68), and 0.31 (95% CI 0.20-0.43), respectively; in men, the corresponding estimates of relative survival were: 0.63 (95% CI 0.48-0.75), 0.48 (95% CI 0.32-0.63), and 0.36 (95% CI 0.18-0.56). On average post hip-fracture women died 4. years earlier (median: 4.1, inter-quartile range (IQR) 1.7-7.8) and men died 5. years earlier (median. = 4.8, IQR 2.4-7.0) than expected. For every six women and for every three men with hip fracture one extra death occurred above that expected in the background population. Conclusion: Hip fracture is associated with reduced life expectancy, with men having a greater reduction than women, even after accounting for time-related changes in background mortality in the population. These data underscore that hip fracture is an independent clinical risk factor for mortality. © 2013 Elsevier Inc.

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