Adjusted Mortality After Hip Fracture: From the Cardiovascular Health Study

  1. John A. Robbins MD, MHS,
  2. Mary L. Biggs MPH,
  3. Jane Cauley DrPH

Article first published online: 7 DEC 2006

DOI: 10.1111/j.1532-5415.2006.00985.x

Issue

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 54, Issue 12, pages 1885–1891, December 2006

Additional Information

How to Cite

Robbins, J. A., Biggs, M. L. and Cauley, J. (2006), Adjusted Mortality After Hip Fracture: From the Cardiovascular Health Study. Journal of the American Geriatrics Society, 54: 1885–1891. doi: 10.1111/j.1532-5415.2006.00985.x

Author Information

  1. From the *Department of Medicine, University of California at Davis, Davis, California†Department of Biostatistics, University of Washington, Seattle, Washington‡Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.

*Address correspondence to John A. Robbins, MD, Division of General Medicine, 4150 V Street, PSSB Suite 2400, Sacramento, CA 95817. E-mail: jarobbins@ucdavis.edu

Publication History

  1. Issue published online: 7 DEC 2006
  2. Article first published online: 7 DEC 2006

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Keywords:

  • hip fracture;
  • mortality;
  • women;
  • elderly

OBJECTIVES: To estimate the risk of death associated with hip fracture (HFx), stratifying by sex and time since fracture.

DESIGN: Prospective cohort study compared participants with and without hip fracture, matched on sex, age, race, recruitment period, and time since enrollment.

SETTING: The Cardiovascular Health Study, a more-than-15-year longitudinal study of 5,888 older individuals from four U.S. sites.

PARTICIPANTS: Three hundred seventy-nine individuals with HFx were compared with 1,134 without HFx.

MEASUREMENTS: Extended Cox models were used to estimate mortality hazard ratios (HRs) for different periods after fracture, adjusting for prefracture health.

RESULTS: Age- and race-adjusted excess mortality was 9% in women and 24% in men 1 year after fracture, and 24% in women and 26% men 5 years postfracture. Multivariable-adjusted HRs of mortality associated with HFx in women were 7.1 (95% confidence interval (CI)=2.3–21.5), 2.1 (95% CI=1.0–4.1), 1.4 (95% CI=1.1–2.0), and 1.0 (95% CI=0.6–1.5) for 0 to 1 months, 2 to 6 months, 7 months to 4 years, and 5 to 8 years, respectively, after index date. In men, respective HRs for the same time periods were 39.9 (95% CI=5.2–308.7), 3.8 (95% CI=1.4–10.3), 1.1 (95% CI=0.7–1.8), and 1.0 (95% CI=0.3–2.7). HRs adjusted for age and race were 20% to 40% higher.

CONCLUSION: The risk of mortality was highest in the first 6 months after HFx. In men, the risk of death approximated that of men without HFx after 6 months; in women, a moderately greater risk persisted through the fourth year. Although the mortality pattern was different in women and men, excess mortality 5 years postfracture was similar for both sexes.

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