Excess mortality after hip fracture among the elderly in Taiwan: A nationwide population-based cohort study

Abstract

Osteoporotic hip fractures cause high mortality in the elderly population. However, few population studies reported the long-term mortality of hip fracture among the elderly in Asian population. This study assessed the incidence, excess mortality, and risk factors after osteoporotic hip fractures through inpatients aged 60 years or older. A total of 143,595 patients with hip fracture were selected from Taiwan National Health Insurance database in the years 1999 to 2009 and followed up until the end of 2010. Annual incidence, mortality and SMR, and mortality and SMR at different periods after fracture were measured. From 1999 to 2005, hip fracture incidence gradually increased and then fluctuated after 2006. From 1999 to 2009, the male-to-female ratio of annual incidence increased from 0.60 to 0.66, annual mortality for hip fracture decreased from 18.10% to 13.98%, male-to-female ratio of annual mortality increased from 1.38 to 1.64, and annual SMR decreased from 13.80 to 2.98. Follow-up SMR at one, two, five, and ten years post-fracture was 9.67, 5.28, 3.31, and 2.89, respectively. Females had higher follow-up SMR in the younger age groups (60-69 yr of age) but lower follow-up SMR in the older age groups (over 80 yr of age) compared with males. Among the studied patients, incidence is gradually decreasing along with annual mortality and SMR. Hip fracture affects short-term but not long-term mortality.

Current trends and future projections of hip fracture in South Korea using nationwide claims data

“…Our current study showed that the female gender had higher SMRs in the younger age groups (50-69 years old) but lower ratios in the older age groups (over age 80). These findings were similar to those reported in Taiwan [26]; the authors of that study suspected that the withdrawal effect of estrogen after menopause would be more pronounced in the younger Asian females.…”

“…We calculated SMRs to indirectly compare the excess mortality rates after hip fracture with those in the general population. Our current study showed that the average SMR 1 year after hip fracture was 10.9 (men: 11.9, women: 11.2), similar to the ratio in Taiwan (9.67) but higher than that in Western countries [26,[29][30][31]. Gender-specific SMRs were found to be consistently higher in males than in females for all age groups in Western countries [31,32].…”

“…In the current study, average mortality rate in Korea at 1 year after hip fracture was still high (total: 16.6 %, 21.0 % in men and 14.8 % in women) from 2008 to 2012, although the rate did level off or decrease. These findings may be attributed to improvements in medical care and technology [26]. The decreasing trends in mortality rates were mainly observed among women.…”

Positive Effects of a Sufficient Pre-fracture Serum Vitamin D Level on the Long-Term Survival of Hip Fracture Patients in Finland: A Minimum 11-Year Follow-Up

“…The increased excess mortality in women compared with men was obvious immediately after the hip fracture operation, persisting surprisingly until the end of the 11-year follow-up. In most of the previous studies, the mortality rates were higher in men than in women [1,[31][32][33]. The opposite result has also been published.…”

Meðferð og afdrif sjúklinga með mjaðmarbrot

“…7 Þrjátíu daga dánartíðni eftir innlögn eða aðgerð er um 8-10% 4,6 og eins árs dánartíðni milli 16-30%. 3,[22][23][24] Dánartíðnin er haerri hjá körlum en konum, 3,4,6 um 30% á móti 20% einu ári eftir brot. 3 Tilgangur þessarar rannsóknar var að gefa yfirlit um meðferð og afdrif sjúklinga sem mjaðmarbrotna og gangast undir aðgerð á Landspítala með sérstakri áherslu á bið eftir aðgerð, búsetu eftir útskrift af sjúkrahúsi og dánartíðni einu ári eftir mjaðmarbrot.…”