December 4, 2007
Last Updated: 2007-12-03 12:04:23 -0400 (Reuters Health)
NEW YORK (Reuters Health) – There have been significant changes in the demographics of hip fracture patients in Denmark over a 20-year period, including increases in mortality and the number of men sustaining hip fractures, along with an overall older age among fracture patients.
Dr. Peter Vestergaard and colleagues from Aarhus University Hospital conducted a register-based cohort study of changes in mortality and causes of death in patients sustaining hip fractures between 1981 and 2001. The findings are published in the November issue of the Journal of the American Geriatrics Society.
Included were all 163,313 patients nationwide who sustained a hip fracture and 505,960 age- and sex-matched controls. The researchers stratified the fracture patients according to treatment: osteosynthesis, arthroplasty, or other. Outcome measures were mortality and cause of death at 30 days and 1 year.
The proportion of men with hip fractures rose significantly from 25.5% to 29.8% during the study period (p < 0.01), and the mean age of patients with hip fracture increased from 75.8 to 78.1 (p < 0.01). The team observed a decrease in 1-year survival among cases, but an increase in survival among the controls.
Mortality was significantly higher among patients who underwent arthroplasty than among those who had osteosynthesis.
Accidents related to the hip fracture were the major cause of both 30-day and 1-year mortality. The proportion of deaths associated with complications related to the trauma that caused the fracture also increased steadily over the 20-year period.
"Part of the increased mortality was linked to lung disease, which indicates a need for measures to improve lung function in patients with asthma, chronic obstructive pulmonary disease, and emphysema suffering a hip fracture," they note. Likewise, psychiatric disease increased mortality in fracture patients.
"This decrease in relative survival after a hip fracture is particularly troubling," the researchers note, "because overall life expectancy has improved in the general population."
J Am Geriatr Soc 2007;55:1720-1726.