ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020
Analysis of mortality after hip fracture on patient, hospital, and regional level in Germany.
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, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Mortality After Osteoporotic Vertebral Body Fractures: Cement Augmentation Versus Conservative Treatment—A Systematic Review and Meta-Analysis.Deutsches Arzteblatt international · 2025Pooled it
- The use of minimum common data set in the development of the Greek Fragility Hip Fracture Registry in the Greek health care setting: the first year of its pilot implementation.Archives of osteoporosis · 2024Article
- Health-economic evaluation of orthogeriatric co-management for patients with pelvic or vertebral fragility fractures.BMC geriatrics · 2024Article
- Mortality and re-fracture rates in low trauma hip fracture.BMC geriatrics · 2024Article
- Unpaid caregiving for people following hip fracture: longitudinal analysis from the English Longitudinal Study of Ageing.European geriatric medicine · 2023Article
- Prognostic value of orthogeriatric assessment parameters on mortality: a 2-year follow-up.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Analysis of the effects of a delay of surgery in patients with hip fractures: outcome and causes.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Association between mortality risk and the number, location, and sequence of subsequent fractures in the elderly.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Design and Evaluation of a Hospital-Based Educational Event on Fracture Care for Older Adult.Geriatric orthopaedic surgery & rehabilitation · 2021Article
- Prevalence of Swallowing and Eating Difficulties in an Elderly Postoperative Hip Fracture Population-A Multi-Center-Based Pilot Study.Geriatrics (Basel, Switzerland) · 2020Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
Knowledge about risk factors of mortality after hip fracture might encourage prevention and further improvements in care. This study identified patient risk factors as well as hospital and regional characteristics associated with a decreased risk. Variation of mortality was largest on patient level and modest on hospital and regional level.
introductionAmong numerous studies analyzing mortality as worst consequence after hip fracture, the majority focused on patient level and fewer on hospital and regional level. Comprehensive knowledge about contributing factors on all levels might help to reveal relevant inequalities, which would encourage prevention and further improvements in care. This study aimed at investigating variation of mortality after hip fracture on patient, hospital, and regional level in Germany.
methodsWe performed a retrospective cohort study on hip fracture patients aged 65 and older using statutory health insurance claims data from Jan 2009 through Dec. 2012 and additional information from the Federal Statistical Office Germany. Regions were classified based on two-digit postal code. We applied a multilevel Cox proportional hazard model with random intercepts on hospital and regional level to investigate the risk factors for mortality within 6 and 12 months after hip fracture.
resultsThe dataset contained information on 123,119 hip fracture patients in 1014 hospitals in 95 German regions. Within 6/12 months, 20.9%/27.6% of the patients died. On patient level, male sex, increasing age, increased pre-fracture care level, and increasing comorbidity were associated with an increased hazard of mortality. Hospitals with increasing hip fracture volume or with orthogeriatric co-management and regions with increased population density were associated with a decreased hazard. Variation was largest on patient level and rather modest on hospital and regional level.
conclusionsThe identification of patient-related risk factors enables prognosticating mortality after hip fracture. After adjusting for those, variation seemed to be attributable rather to hospitals than to regions.
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