Long-term survival and fracture risk after hip fracture: a 22-year follow-up in women
Hip fracture is associated with high early mortality. Little is known about long-term survival and subsequent fracture risk. The aim of this study [1] was to evaluate survival and fracture risk after hip fracture in women at different ages. All women suffering a hip fracture during 1984–1985 in Malmö, Sweden, were identified (n = 766) and followed up to 22 y or death. All new radiographic examinations related to musculoskeletal trauma with or without fracture were registered. Survival (mortality) and fracture was evaluated in 5-y age bands and in age groups (<75, 75–84, and >85 y).
Mean age was 79.6 ± 9.9 y, with 42% between 75 and 85 y of age. Overall 22-y survival was 6%: 79% at 1 y, 48% at 5 y, and 33% at 10 y (i.e., population at risk). One-year mortality was 7%, 21%, and 33% for <75, 75–84, and >85 y of age, respectively, and 95% of those >85 y were dead at 10 y. A total of 768 fractures were registered at 715 occasions in 342 women (45%; mean, 2.3 fractures/woman; range, 1–11 fractures/woman). Of the fracture occasions, 15% occurred within the first year, 27% within 2 y, and 73% within 5 y. The residual lifetime fracture risk was 45%, with a mortality-adjusted increase to 86%. The 10-y fracture risk was 40%, with a mortality-adjusted increased to 65%.
In conclusion, almost one half of all women with a hip fracture suffer a new fracture during their remaining lifetime. Fracture risk is highly dependent on age and survival, emphasizing that preventive strategies need to be tailored to each age group specifically.
- von Friesendorff M et al. J Bone Miner Res. 2008;23:1832–1841.
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