Five-Year Relative Survival of Patients With Osteoporotic Hip Fracture

Context: Osteoporotic hip fracture is known to be associated with excess mortality. The 1-year mortality rate after hip fracture is known to reach up to similar to 20%, similar to that of cancer. However, there was no study that compared cancer survival. Recently, relative survival has been used to present a prognosis for a particular disease. Objective: The purpose of this study was to compare the 5-year relative survival after osteoporotic hip fracture with those of general population and cancer patients. Design, Setting, and Patients: We retrospectively reviewed the medical records of 727 patients who were treated for osteoporotic hip fractures from 2003 to 2009. Intervention: Intervention was hip fracture surgery. Main Outcome Measure: Five-year relative survival after fracture was estimated and was compared with survival in the general population and in cancer patients. Relative survival of 100% would reflect no excess mortality associated with the hip fracture compared with the general population. Results: Cumulative mortality was 32.3% at 5 years, and 5-year absolute survival rate was 63.0% (95% confidence interval, 59.0%-66.9%). Five-year relative survival of hip fracture was 93.9% (95% confidence interval 87.5%-99.7%), which was comparable with those of thyroid or breast cancer (99.8% and 91.0%, respectively). Conclusions: Our results showed that 5-year relative survival after osteoporotic hip fracture was below those of the general populations and was comparable with some cancers such as thyroid and breast cancer. Therefore, osteoporotic hip fracture should not be overlooked.