Predictors of first hip fracture and mortality post fracture in older women

Fitzpatrick, Patricia; Kirke, P. N.; Daly, Leslie; Rooij, Iris A. L. M. van; Dinn, E.; Burke, Helen; Heneghan, J.; Bourke, G J; Masterson, J.

doi:10.1007/bf03167722

Cited by 25 publications

(15 citation statements)

References 22 publications

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“…Calcium and vitamin D deficiency are associated with hip fracture incidence, and these dietary factors are unevenly distributed among socioeconomic groups 42 44. Physical functioning seems to be associated with an increased risk of hip fractures 45. Data from the Whitehall 2 study suggest a widening of socioeconomic disparities in physical functioning in the elderly 12.…”

Section: Discussionmentioning

confidence: 99%

Childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures after 13 years of follow-up: the role of health behaviours

Lenthe

Avendaño

Beeck

et al. 2011

Journal of Epidemiology & Community Health

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Section: Discussionmentioning

confidence: 99%

Childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures after 13 years of follow-up: the role of health behaviours

Lenthe

Avendaño

Beeck

et al. 2011

Journal of Epidemiology & Community Health

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“…Little is known about social class and post-fracture mortality: one study reported no association,22 and another reported higher mortality in lower social classes 23. Population based all cause mortality is higher in social classes IV and V than in classes I and II.…”

Section: Discussionmentioning

confidence: 99%

Time trends and demography of mortality after fractured neck of femur in an English population, 1968-98: database study

Roberts

Goldacre²

2003

BMJ

276

157

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Objectives To investigate time trends in mortality after admission to hospital for fractured neck of femur from 1968 to 1998, and to report on the effects of demographic factors on mortality. Design Analysis of hospital inpatient statistics for fractured neck of femur, incorporating linkage to death certificates. Setting Four counties in southern England. Subjects 32 590 people aged 65 years or over admitted to hospital with fractured neck of femur between 1968 and 1998. Main outcome measures Case fatality rates at 30, 90, and 365 days after admission, and standardised mortality ratios at monthly intervals up to one year after admission. Results Case fatality rates declined between the 1960s and the early 1980s, but there was no appreciable fall thereafter. They increased sharply with increasing age: for example, fatality rates at 30 days in 1984-98 increased from 4% in men aged 64-69 years to 31% in those aged ≥ 90. They were higher in men than women, and in social classes IV and V than in classes I and II. In the first month after fracture, standardised mortality ratios in women were 16 times higher, and those in men 12 times higher, than mortality in the same age group in the general population. Conclusions The high mortality rates, and the fact that they have not fallen over the past 20 years, reinforce the need for measures to prevent osteoporosis and falls and their consequences in elderly people. Whether post-fracture mortality has fallen to an irreducible minimum, or whether further decline is possible, is unclear.

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“…10 In their study, subjects with cancer, major trauma, fractures at other sites, or moderate to severe cognitive impairment were excluded. We found that diagnosed osteoporosis was significantly associated with the risk of lower limb fractures (RR 1.9, 95% CI 1.7 to 2.2) and was an important predictor for hip and femur fracture in the elderly (population attributable risk 3.7% among 50-79 year olds and 3.6% among subjects 80 years and older).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of lower limb fractures in general practice in the United Kingdom

Kaye¹

2004

Inj Prev

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Study objective: To estimate the incidence of lower limb fractures in the United Kingdom and assess the relative importance of various risk factors for lower limb fractures. Design: Cohort analysis and matched case-control study. Setting: General practices contributing information to the General Practice Research Database. Subjects: Individuals registered with these general practices who were at risk for a first time lower limb fracture from 1 January1990 to 31 December 2001. Main outcome measures: Age, sex, and fracture site specific incidence rates; relative risks and population attributable risks for various medical risk factors. Results: Overall, the risk of lower limb fracture was 17% higher in women then in men. Within age groups, men and women had generally similar proportions of fractures at specific sites in the lower limb. Among the risk factors evaluated, road collisions were associated with the highest relative risk for lower limb fracture, but only accounted for 3.1% or less of the population attributable risk for specific fracture types in any age group. The relative risk for lower limb fracture associated with a diagnosis of dementia was 2.3 (95% confidence interval 2.0 to 2.6), while relative risk estimates for other medical diagnoses were less than 2. Fracture risk was increased among current users of corticosteroids, antipsychotics, antidepressants, and hypnotic/sedatives, but the population attributable risks for each of these drug classes within fracture and age specific strata were only 3.0% or less. Conclusions: Many risk factors for lower limb fracture have been identified, but population attributable risk estimates for various risk factors are small. These findings suggest that multifactorial prevention programs are needed to decrease the incidence of lower limb fractures in the general population.

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Predictors of first hip fracture and mortality post fracture in older women

Cited by 25 publications

References 22 publications

Childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures after 13 years of follow-up: the role of health behaviours

Childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures after 13 years of follow-up: the role of health behaviours

Time trends and demography of mortality after fractured neck of femur in an English population, 1968-98: database study

Epidemiology of lower limb fractures in general practice in the United Kingdom

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