ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2021
Excess mortality after hip fracture: fracture or pre-fall comorbidity?
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, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 29 citations in OpenAlex.
- The association between different ejection fractions and all-cause mortality in aged patients with hip fractures: a retrospective cohort study and the development of a predictive model.BMC musculoskeletal disorders · 2026Article
- The influence of muscle size and density, as well as subcutaneous adipose tissue, on mortality risk in elderly women across different age groups.BMC musculoskeletal disorders · 2025Article
- The size and density of muscle and subcutaneous adipose tissue are independently associated with the risk of mortality in older women with different hip fracture types.Journal of orthopaedic surgery and research · 2025Article
- Real-life effectiveness of a Fracture Liaison Service in reducing short-term mortality and second fractures after hip fracture: a five-year prospective study.Archives of osteoporosis · 2025Article
- Fusion of X-Ray Images and Clinical Data for a Multimodal Deep Learning Prediction Model of Osteoporosis: Algorithm Development and Validation Study.JMIR medical informatics · 2025Article
- The local application of a 1% simvastatin gel improves bone regeneration in osteoporotic mandibular defects: a rat model study.Annals of medicine and surgery (2012) · 2025Article
- Optimizing Surgical Strategies for Elderly Patients With Femoral Neck Fracture: The Critical Role of Comorbidities.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Effects of Protocol-driven Care by Internists on Adherence to Clinical Practice Guidelines for Hip Fracture Surgery Patients: An Interrupted Time Series Study Using a Nationwide Inpatient Database.Internal medicine (Tokyo, Japan) · 2025Article
- How accurately do finite element models predict the fall impact response of ex vivo specimens augmented by prophylactic intramedullary nailing?Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- Article
- Analysis of structural variations and effects of the national volume-based procurement policy on inpatient costs: a real world study of osteoporotic hip fractures in Shanghai, China.Frontiers in public health · 2025Article
- Associations between multimorbidity and unintentional falls among older adults with coronary heart disease.Frontiers in public health · 2025Article
- The association between preoperative serum cholinesterase and all-cause mortality in geriatric patients with hip fractures: a cohort study of 2387 patients.Perioperative medicine (London, England) · 2024Article
- Chronic pain in older adults with disabilities is associated with fall-related injuries: a prospective cohort study.European geriatric medicine · 2024Article
- The association between prealbumin concentration at admission and mortality in elderly patients with hip fractures: a cohort study.Archives of osteoporosis · 2024Article
- Muscle size and density are independently associated with death after hip fracture: A prospective cohort study.Journal of cachexia, sarcopenia and muscle · 2023Article
- The association between hemoglobin at admission and mortality of older patients with hip fracture: a mean 3-year follow-up cohort study.European geriatric medicine · 2023Article
- Predictability of Neutrophil to Lymphocyte Ratio in preoperative elderly hip fracture patients for post-operative short-term complications: a retrospective study.BMC musculoskeletal disorders · 2023Review
- Predictors of 10-year Mortality After Hip Fracture Surgery in a Pre-Pandemic Cohort.Geriatric orthopaedic surgery & rehabilitation · 2023Article
- Pelvic Fractures-An Underestimated Problem? Incidence and Mortality Risk after Pelvic Fracture in Austria, 2010-2018.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Comorbidity and hip fracture independently increased mortality risk for 9 years in both sexes, with a significant additive interaction in the first year among women and through 6 years among men.
introductionHip fracture is associated with a persistently elevated mortality risk, but it is unknown whether the elevated risk is due to the fracture or to pre-fracture comorbidity.
methodsIn a population-based study in Singapore with 9 years of follow-up, patients age > 50 with first hip fracture from 2008 to 2017 were pair-matched to a cohort without hip fracture by age, sex, ethnicity, and pre-fracture Charlson Comorbidity Index (CCI). We investigated additive interaction using the relative excess risk due to interaction (RERI) and multiplicative interaction using the ratio of relative risks.
resultsTwenty-two thousand five hundred ninety of 22,826 patients with a first hip fracture in 2008-2017 were successfully matched. Hip fracture and comorbidity independently increased mortality risk for 9 years in both sexes. After adjustment for comorbidity, excess mortality risk continued to persist for 9 years post-fracture in both men and women. Women with a hip fracture and pre-fracture CCI > 4 had a higher relative risk (RR) of mortality at 9 years of 3.29 [95% confidence interval (CI) 3.01, 3.59] than those without comorbidity (RR 1.51, 95%CI 1.36, 1.68) compared to the referent without hip fracture or comorbidity. An additive interaction between hip fracture and pre-fracture CCI > 4 was observed in the first post-fracture year` [relative excess risk due to interaction (RERI) 1.99, 95%CI 0.97, 3.01]. For men with CCI ≥ 4, the positive additive interaction was observed through 6 years.
conclusionsExcess mortality risks post-fracture are attributable to both the fracture and pre-fracture comorbidity. Early interventions in hip fracture patients with high comorbidity could reduce their excess mortality.
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