Hong Kong study shows lower survival rates after second hip fractures

Research presented today at the 4th Asia-Pacific Osteoporosis Meeting showed that second hip fractures are more deadly than first hip fractures. Based in Hong Kong, the study evaluated the overall incidence of a second hip fracture and subsequent mortality in 43,832 patients, aged 65 or above, with operatively treated first hip fracture during the years 2000-2011. The patients' mean age was 82±7.38 and the male to female ratio was 3:7. A total of 2,399 second hip fractures were identified.

On average, second hip fractures occurred 2 years and 8 months after the primary . Females had a higher incidence of second hip fracture. The overall incidence of a second fracture was 0.88% at 6 months, 1.81% at 1 year, 6.91% at 5 years and 9.95% at 10 years. A total 75% of second fractures occurred within around 4 years after the initial fracture.

The median survival after single fracture was 4 years 10 months, while second fracture was 3 years 8 months. Lower survival was observed in second fracture (HR 5.44, 95%CI 1.67-11.1, p<0.001) and in males (HR 1.91, 95%CI 1.86-1.96, p<0.05). Older patients had a minimal risk for increase mortality (HR 1.061, 95%CI 1.059-1.063, p<0.05).

The authors concluded that further studies are needed to help explain the excessive mortality of second hip fracture compared to primary hip . Furthermore, they suggest that early initiation of treatment and a fragility fracture prevention programme after primary hip fracture could help reduce second fracture incidence and related mortality.

More information: Abstract OC 16: Second hip fracture in Hong Kong Chinese: incidence, epidemiology and mortality. Osteoporos Int, Vol. 2, Suppl. 4, DOI: 10.1007/s00198-013-2536-x

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