Abstract
Backgrounds
Hip fractures have significant excess mortality, but it is unknown how long excess mortality persists. Our study was to explore the short and long term excess mortality after hip fractures, assess the impact of hip fracture on excess mortality and estimate the population attributable risk proportion (PARP) of risk factors for excess mortality.
Methods
A total of 216 elderly with first time low trauma hip fracture admitted to NTUH were age and sex matched with 215 elder patients from Geriatric Department of the same hospital. All 63 covariates associated with mortality were analyzed using COX regression model. The survival status of these subjects was followed through National Death Registry for 60 months.
Results
Hip fracture patients had an increased mortality in the first year after fractures compared with controls (Multivariable adjusted odds ratio {OR}: 2.4; 95% CI 1.05–5.4; PAR: 44.7%). At 60 months follow-up, the excess mortality of hip fracture remained high (OR: 2.7; 95% CI 1.3–5.5; PAR: 48.0%). Risk factors for short term mortality were hip fracture, betel nut use, comorbidities and MMSE< 19. Risk factors for long term mortality were hip fracture, ADL difficulty, smoking, coordination abnormality, T score < −2.19, BMI< 20 and the existence of comorbidities.
Conclusions
Excess mortality after hip fracture lasts beyond 5 years. Excess mortality is attributable to hip fracture, which has higher PARP than other risk factors in both short and long term mortality.
