Fractures

Fractures Raise Long-Term Mortality Risk

Fragility fractures of various types are associated with long-term mortality risk, according to new research.

 

These findings emerged from a study of 21,123 women and 9481 men in Denmark aged 50 years and older with incident fragility fractures in 2001. Follow-up lasted up to 10 years.

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Relative survival analysis was performed in order to assess the relationship between fractures and mortality at specific time intervals post-fracture. Time-related changes in mortality were also taken into consideration.

 

Overall, 10,668 women and 4745 men died throughout the study. Results of the study demonstrated associations between excess mortality and all proximal and lower leg fractures. The association between fractures and excess mortality declined over time, as most deaths occurred within the first year following fracture.

 

Hip fractures led to the highest excess mortality in this cohort, contributing to 33% of deaths among women and 20% of deaths among men at 1 year post-fracture.

 

For other fractures, excess mortality at 1 year post-fracture was:

 

  • Femur or pelvis fractures: 20% to 25%
  • Vertebral fractures: 10%
  • Humerus, rib, or clavicle fractures: 5% to 10%
  • Lower leg fractures: 3%

 

Though the risk became smaller with time, the association between hip fractures and excess mortality risk persisted until 10 years post-fracture. Additionally, the association between femur, other proximal, and lower leg fractures lasted until 5 years post-fracture and also declined over time.

 

“This study highlights the important contribution of a wide variety of fragility fractures to long-term excess mortality, and thus the potential for benefit from early intervention,” the researchers concluded.

 

—Christina Vogt

 

Reference:

Tran T, Bliuc D, Hansen L, et al. Persistence of excess mortality following individual non-hip fractures: A relative survival analysis [Published online July 19, 2018]. J Clin Endocrinol Metab. https://doi.org/10.1210/jc.2017-02656