Adjusted mortality after hip fracture

From the cardiovascular health study

John A Robbins, Mary L. Biggs, Jane Cauley

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1885-1891
Number of pages7
JournalJournal of the American Geriatrics Society
Volume54
Issue number12
DOIs
StatePublished - Dec 2006

Fingerprint

Hip Fractures
Confidence Intervals
Mortality
Health
Proportional Hazards Models
Longitudinal Studies
Cohort Studies
Prospective Studies

Keywords

  • Elderly
  • Hip fracture
  • Mortality
  • Women

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Adjusted mortality after hip fracture : From the cardiovascular health study. / Robbins, John A; Biggs, Mary L.; Cauley, Jane.

In: Journal of the American Geriatrics Society, Vol. 54, No. 12, 12.2006, p. 1885-1891.

Research output: Contribution to journalArticle

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title = "Adjusted mortality after hip fracture: From the cardiovascular health study",
abstract = "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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AU - Biggs, Mary L.

AU - Cauley, Jane

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N2 - 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.

AB - 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.

KW - Elderly

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