Hip fracture often deadly, Australian study shows

Hip fracture is a major public health problem, associated with high morbidity and mortality, and high costs to the healthcare system. With the ageing of populations worldwide, the socioeconomic burden of hip fracture is set to rise dramatically.

A new Australian study published in Archives of Osteoporosis, looks at the 12-month mortality of older persons presenting to hospitals in Australia with hip fracture. It is the first large population-based matched cohort study exploring excess mortality risk from hip fracture in the Australian population while accounting for pre-injury comorbid conditions.

The researchers linked hospital and mortality data from four Australian states. 9748 Individuals aged 65 years and older who had a hospital admission with a primary diagnosis of hip fracture in 2009 were matched 1:1 on age, sex, and postcode of residence with a cohort of non-injured individuals selected from the electoral roll. Adjusted mortality rate ratios and attributable risk percent were calculated, and Cox proportional hazard regression was used to examine the effect of risk factors on survival.

The researchers found that hip fracture sufferers experienced significantly worse survival at 12-months post-fracture:

• Individuals with hip fracture were more than 3.5 times more likely to die within 12 months compared to their non-injured counterparts (mortality rate ratio 3.62 [95%CI 3.23-4.05]).
• Hip fracture was likely to be a contributory factor in 72% of mortality within 12 months after the index hospital admission.
• Excess mortality risk at 12 months was higher in males than in females, and in the 65-74-year age group compared to older age groups.

Dr Reidar P. Lystad from the Australian Institute of Health Innovation at Macquarie University and co-author of the study, stated:

"With an ageing population in Australia, the burden of hip fractures is expected to increase in the coming decades. Our findings suggest that, with the hip fracture trauma itself a main predictor of excess mortality, efforts may best be directed at primary and secondary prevention of the fracture itself."