hip replacement

Hip Fractures Increase Mortality Risk in Older Adults

According to a recent study, hip fractures are associated with increased risk of all-cause mortality in older adults.

Researchers evaluated data from 122,808 participants who were divided into 8 cohorts across Europe and the United States, with a median follow-up of 12.6 years. Telephone interviews and questionnaires and national inpatient/fracture registries were used to determine incidences of hip fractures, and death certificates were used to verify death.

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The association between hip fracture and mortality and its magnitude at different time intervals after injury were assessed using Cox proportional hazard models and time-dependent variable methodology. In addition, researchers obtained the effect estimated through a random-effects meta-analysis.

During the study, there were 4273 incidences of hip fractures and 27,999 deaths. Overall, hip fractures were associated with increased risk of all-cause mortality (hazard ratio 2.12).

Their findings showed higher incidences of mortality within the first year after a hip fracture, and that the risk remained elevated long after the initial injury. Hazard ratios for mortality after a hip fracture were 1.89 from 1 to 4 years after injury, 2.15 from 4 to 8 years after injury, and 1.79 for 8 years or more after injury.

In addition, researchers found a stronger association between hip fractures and mortality in men (hazard ratio 2.39) than women (hazard ratio 1.92), although the difference was not significant.

“In 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,” the researchers concluded.

—Melissa Weiss


Katsoulis M, Benetou V, Karapetyan T, et al. Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project [published online January 17, 2017]. Journal of Internal Medicine. doi:10.1111/joim.12586.