Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project

Journal of Internal Medicine - Tập 281 Số 3 - Trang 300-310 - 2017
Michail Katsoulis1, Vassiliki Benetou2, Tina Karapetyan1, Diane Feskanich3, Francine Grodstein3, U Pettersson4, Sture Eriksson5, Tom Wilsgaard6, Lone Jørgensen7, Luai A. Ahmed8, Ben Schöttker9, Hermann Brenner9, Andrea Bellavia10, Alicja Wolk10, Carl Lachat11, Bernardine H. Stegeman12, Martin Bobák12, Paolo Boffetta1,13, Hanno Ulmer1
1Hellenic Health Foundation, Athens, Greece
2School of Medicine Department of Hygiene, Epidemiology and Medical Statistics National and Kapodistrian University of Athens Athens Greece
3Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
4Department of Pharmacology and Clinical Neurosciences and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
5Faculty of Medicine Department of Community Medicine and Rehabilitation, Geriatric Medicine Umeå University Umeå Sweden
6Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
7Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
8Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
9Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
10Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
11National Institute of Public Health, Prague, Czech Republic
12Department of Epidemiology and Public Health, University College London, London, UK
13Institute for Translational Epidemiology and Tisch Cancer Institute Icahn School of Medicine at Mount Sinai New York NY USA

Tóm tắt

AbstractBackgroundHip fractures are associated with diminished quality of life and survival especially amongst the elderly.ObjectiveAll‐cause mortality after hip fracture was investigated to assess its magnitude.MethodsA total of 122 808 participants from eight cohorts in Europe and the USA were followed up for a mean of 12.6 years, accumulating 4273 incident hip fractures and 27 999 deaths. Incident hip fractures were assessed through telephone interviews/questionnaires or national inpatient/fracture registries, and causes of death were verified with death certificates. Cox proportional hazards models and the time‐dependent variable methodology were used to assess the association between hip fracture and mortality and its magnitude at different time intervals after the injury in each cohort. We obtained the effect estimates through a random‐effects meta‐analysis.ResultsHip fracture was positively associated with increased all‐cause mortality; the hazard ratio (HR) in the fully adjusted model was 2.12, 95% confidence interval (CI) 1.76–2.57, after adjusting for potential confounders. This association was stronger amongst men [HR: 2.39, 95% CI: 1.72–3.31] than amongst women [HR: 1.92, 95% CI: 1.54–2.39], although this difference was not significant. Mortality was higher during the first year after the hip fracture [HR: 2.78, 95% CI: 2.12–3.64], but it remained elevated without major fluctuations after longer time since hip fracture [HR (95% CI): 1.89 (1.50–2.37) after 1–4 years; 2.15 (1.81–2.55) after 4–8 years; 1.79 (1.57–2.05) after 8 or more years].ConclusionIn this large population‐based sample of older persons across eight cohorts, hip fracture was associated with excess short‐ and long‐term all‐cause mortality in both sexes.

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Journal of Internal Medicine

Tập 281 Số 3

300-310

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