ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2013
The contributions of First Nations ethnicity, income, and delays in surgery on mortality post-fracture: a population-based analysis.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Postoperative outcomes for Indigenous Peoples in Canada: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Pooled it
- Socio-economic inequalities in fragility fracture outcomes: a systematic review and meta-analysis of prognostic observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Pooled it
- Refracture and Mortality Following Surgical Management of Osteoporotic Vertebral Fractures: A Systematic Review and Meta-Analysis with Patient-Level Survival Modeling.Journal of clinical medicine · 2025Review
- Association between Fractures and Low Muscle Mass in Korean Menopausal Women: Data from Korean National Health and Nutrition Survey (2010-2011).Journal of menopausal medicine · 2023Article
- The Surgical Timing and Prognoses of Elderly Patients with Hip Fractures: A Retrospective Analysis.Clinical interventions in aging · 2023Article
- Comparison of femoral neck geometric parameters between Chinese and Japanese females.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2022Article
- Prevalence of Sarcopenia and Its Association with Quality of Life, Postural Stability, and Past Incidence of Falls in Postmenopausal Women with Osteoporosis: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2022Article
- Effect of Body Surface Area on Severe Osteoporotic Fractures: A Study of Osteoporosis in Changsha China.Frontiers in endocrinology · 2022Article
- Relationship between bone mineral density and fragility fracture risk: a case-control study in Changsha, China.BMC musculoskeletal disorders · 2021Article
- Excess of all-cause mortality after a fracture in type 2 diabetic patients: a population-based cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
- Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology.Bone reports · 2017Review
- Comparison of fracture rates between indigenous and non-indigenous populations: a systematic review protocol.BMJ open · 2016Article
- Economic inequalities amongst women with osteoporosis-related fractures: an application of concentration index decomposition.Health promotion perspectives · 2016Article
- Osteoporosis management and fractures in the Métis of Ontario, Canada.Archives of osteoporosis · 2015Article
- A prediction model for adverse outcome in hospitalized patients with diabetes.Diabetes care · 2013Article
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6 authors.
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Abstract
unlabelledWe examined the independent contributions of First Nations ethnicity and lower income to post-fracture mortality. A similar relative increase in mortality associated with fracture appears to translate into a larger absolute increase in post-fracture mortality for First Nations compared to non-First Nations peoples. Lower income also predicted increased mortality post-fracture.
introductionFirst Nations peoples have a greater risk of mortality than non-First Nations peoples. We examined the independent contributions of First Nations ethnicity and income to mortality post-fracture, and associations with time to surgery post-hip fracture.
methodsNon-traumatic fracture cases and fracture-free controls were identified from population-based administrative data repositories for Manitoba, Canada (aged≥50 years). Populations were retrospectively matched for sex, age (within 5 years), First Nations ethnicity, and number of comorbidities. Differences in mortality post-fracture of hip, wrist, or spine, 1996-2004 (population 1, n=63,081), and the hip, 1987-2002(Population 2, n=41,211) were examined using Cox proportional hazards regression to model time to death. For hip fracture, logistic regression analyses were used to model the probability of death within 30 days and 1 year.
resultsPopulation 1: First Nations ethnicity was associated with an increased mortality risk of 30-53% for each fracture type. Lower income was associated with an increased mortality risk of 18-26%. Population 2: lower income predicted mortality overall (odds ratio (OR) 1.15, 95% confidence interval (CI) 1.07-1.23) and for hip fracture cases (OR 1.18, 95%CI 1.05-1.32), as did older age, male sex, diabetes, and >5 comorbidities (all p≤0.01). Higher mortality was associated with pertrochanteric fracture (OR 1.14, 95% CI 1.03-1.27), or surgery delay of 2-3 days (OR 1.34, 95% CI 1.18-1.52) or ≥4 days (OR 2.35, 95% CI 2.07-2.67).
conclusionA larger absolute increase in mortality post-fracture was observed for First Nations compared to non-First Nations peoples. Lower income and surgery delay>2 days predicted mortality post-fracture. These data have implications regarding prioritization of healthcare to ensure targeted, timely care for First Nations peoples and/or individuals with lower income.
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