期刊
JOURNAL OF INTERNAL MEDICINE
卷 281, 期 3, 页码 300-310出版社
WILEY
DOI: 10.1111/joim.12586
关键词
ageing; bone; CHANCES; hip fracture; mortality
资金
- European Union [HEALTH-F3-2010-242244]
- EPIC-Elderly Greece: the Hellenic Health Foundation
- EPIC-Elderly Umea, Sweden: the Swedish Cancer Society
- EPIC-Elderly Umea, Sweden: the Swedish Research Council
- ESTHER, Germany: the Baden-Wurttemberg State Ministry of Science, Research and Arts (Stuttgart, Germany)
- ESTHER, Germany: the Federal Ministry of Education and Research (Berlin, Germany)
- ESTHER, Germany: Federal Ministry of Family Affairs, Senior Citizens, Women and Youth (Berlin)
- Tromso Study: UiT-The Arctic University of Norway
- Tromso Study: National Screening Services
- Tromso Study: Research Council of Norway, Northern Norway Regional Health Authority
- Tromso Study: Norwegian Council on Cardiovascular Diseases
- Tromso Study: Norwegian Foundation for Health and Rehabilitation
- Tromso Study: Norwegian Diabetes Association
- Tromso Study: Cancer Registry of Norway
- Tromso Study: Odd Berg Group Research Fund
- Tromso Study: Troms County Council
- COSM, Karolinska Institutet, Sweden: the Swedish Research Council Karolinska Institutet's Strategic Foundation
- COSM, Karolinska Institutet, Sweden: Uppsala University
- COSM, Karolinska Institutet, Sweden: Swedish Cancer Society
- SMC, Karolinska Institutet, Sweden: the Swedish Research Council Karolinska Institutet's Strategic Foundation
- SMC, Karolinska Institutet, Sweden: Uppsala University
- SMC, Karolinska Institutet, Sweden: Swedish Cancer Society
- NHS: the National Cancer Institute [P01CA87969]
Background Hip fractures are associated with diminished quality of life and survival especially amongst the elderly. Objective All-cause mortality after hip fracture was investigated to assess its magnitude. Methods A total of 122 808 participants from eight cohorts in Europe and the USA were followed up for a mean of 12.6 years, accumulating 4273 incident hip fractures and 27 999 deaths. Incident hip fractures were assessed through telephone interviews/questionnaires or national inpatient/fracture registries, and causes of death were verified with death certificates. Cox proportional hazards models and the time-dependent variable methodology were used to assess the association between hip fracture and mortality and its magnitude at different time intervals after the injury in each cohort. We obtained the effect estimates through a random-effects meta-analysis. Results Hip fracture was positively associated with increased all-cause mortality; the hazard ratio (HR) in the fully adjusted model was 2.12, 95% confidence interval (CI) 1.76-2.57, after adjusting for potential confounders. This association was stronger amongst men [HR: 2.39, 95% CI: 1.72-3.31] than amongst women [HR: 1.92, 95% CI: 1.54-2.39], although this difference was not significant. Mortality was higher during the first year after the hip fracture [HR: 2.78, 95% CI: 2.12-3.64], but it remained elevated without major fluctuations after longer time since hip fracture [HR (95% CI): 1.89 (1.50-2.37) after 1-4 years; 2.15 (1.81-2.55) after 4-8 years; 1.79 (1.57-2.05) after 8 or more years]. Conclusion In this large population-based sample of older persons across eight cohorts, hip fracture was associated with excess short- and long-term all-cause mortality in both sexes.
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