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Adjusted mortality after hip fracture: From the cardiovascular health study.

TitleAdjusted mortality after hip fracture: From the cardiovascular health study.
Publication TypeJournal Article
Year of Publication2006
AuthorsRobbins, JA, Biggs, ML, Cauley, J
JournalJ Am Geriatr Soc
Volume54
Issue12
Pagination1885-91
Date Published2006 Dec
ISSN0002-8614
KeywordsAged, Cohort Studies, Female, Health Status, Health Surveys, Hip Fractures, Humans, Male, Mortality, Multicenter Studies as Topic, Proportional Hazards Models, Sex Distribution, Time Factors, United States
Abstract<p><b>OBJECTIVES: </b>To estimate the risk of death associated with hip fracture (HFx), stratifying by sex and time since fracture.</p><p><b>DESIGN: </b>Prospective cohort study compared participants with and without hip fracture, matched on sex, age, race, recruitment period, and time since enrollment.</p><p><b>SETTING: </b>The Cardiovascular Health Study, a more-than-15-year longitudinal study of 5,888 older individuals from four U.S. sites.</p><p><b>PARTICIPANTS: </b>Three hundred seventy-nine individuals with HFx were compared with 1,134 without HFx.</p><p><b>MEASUREMENTS: </b>Extended Cox models were used to estimate mortality hazard ratios (HRs) for different periods after fracture, adjusting for prefracture health.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSION: </b>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.</p>
DOI10.1111/j.1532-5415.2006.00985.x
Alternate JournalJ Am Geriatr Soc
PubMed ID17198494
Grant ListN01-HC-15103 / HC / NHLBI NIH HHS / United States
N01-HC-35129 / HC / NHLBI NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States