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Predictors of first hip fracture and mortality post fracture in older women

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Abstract

Background

Hip fracture causes significant morbidity and mortality in older women.

Aim

To document factors contributing to the risk of hip fracture in older women and to assess the effect of hip fracture on subsequent mortality.

Methods

Case-control study of 89 women with hip fracture and 89 controls, with two-year follow-up. Singh index and bone mineral density were calculated.

Results

Osteoporotic indices did not differ significantly between cases and controls. Significant predictors of risk were sleeping tablets, perception of health as fair/poor and a lower mental status score. Patients were 3.57 times more likely to die in the first year after fracture, with no difference between the groups in year two. After adjustment, hip fracture did not remain significantly associated with mortality. Inability to walk 100 yards alone prior to fracture and lower social class were significantly associated with mortality at 12 months. Age alone was significantly associated at 12–24 months.

Conclusions

Factors related to falls and fracture may be more discriminatory predictors of hip fracture risk than osteoporosis in older females. Medications for sleep should be prescribed with caution. Hip fracture may have an independent effect on one year mortality, this effect is not seen in the second year.

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References

  1. Gumming RG, Nevitt MC, Cumrnings SR. Epidemiology of hip fractures.Epidemiol Rev 1997; 19: 244–57.

    Google Scholar 

  2. Dargent-Molina P, Favier F, Grandjean H et al. Fall-related factors and risk of hip fracture: the EPIDOS prospective study.Lancet 1996; 348: 145–9.

    Article  PubMed  CAS  Google Scholar 

  3. Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD. Hip fractures in the elderly: predictors of one year mortality.J Orthop Trauma 1997; 11: 162–5.

    Article  PubMed  CAS  Google Scholar 

  4. Wolinsky FD, Fitzgerald JF, Stump TE. The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study.Am J Public Health 1997; 87: 398–403.

    Article  PubMed  CAS  Google Scholar 

  5. Hamlet WP, Lieberman JR, Freedman EL et al. Influence of health status and the timing of surgery on mortality in hip fracture patients.Am J Orthop 1997; 26: 621–7.

    PubMed  CAS  Google Scholar 

  6. Kamal A, Brocklehurst JC. A colour atlas of geriatric medicine. Wolfe Publishing Ltd, London1992.

    Google Scholar 

  7. O’Hare A, Whelan CT, Commins P. The development of an Irish Census-based Social Class Scale.The Economic and Social Review 1991; 22: 135–56.

    Google Scholar 

  8. McDowell I, Newell C, Ed. Measuring health. Oxford University Press, New York 1996.

    Google Scholar 

  9. Heneghan JP, Kirke PN, Murphy BL et al. Evaluation of quantitative CT vertebral bone mineral density measurement and the Singh index in elderly females with hip fractures—a case-control study.Br J Radiol 1997; 70: 923–8.

    PubMed  CAS  Google Scholar 

  10. Grisso JA, Kelsey JL, Strom BL et al. Risk factors for hip fracture in black women.New Engl J Med 1994; 330: 1555–9.

    Article  PubMed  CAS  Google Scholar 

  11. Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures.Br Med J 1996; 312: 1254–9.

    CAS  Google Scholar 

  12. Cummings SR, Black DM, Nevitt MC. Bone density at various sites for prediction of hip fractures.Lancet 1993; 341: 72–5.

    Article  PubMed  CAS  Google Scholar 

  13. Kelsey JL, O’Brien LA, Grisso JA, Hoffman S. Issues in carrying out epidemiologic research in the elderly.Am J Epidemiol 1989; 130: 857–66.

    PubMed  CAS  Google Scholar 

  14. Moritz DJ, Kelsey JL, Grisso JA. Hospital controls versus community controls: differences in inferences regarding risk factors for hip fracture.Am J Epidemiol 1997; 145: 653–60.

    PubMed  CAS  Google Scholar 

  15. Gumming RG. Nursing home residence and risk of hip fracture.Am J Epidemiol 1996; 143: 1191–6.

    Google Scholar 

  16. Buchner DM, Larson EB. Falls and fractures in patients with Alzheimer-type dementia.JAMA 1987; 257: 1492–5.

    Article  PubMed  CAS  Google Scholar 

  17. Ray WA, Griffin MR, Schaffner W, Baugh DK, Melton LJ. Psychotropic drug use and the risk of hip fracture.New Engl J Med 1987; 316: 363–9.

    Article  PubMed  CAS  Google Scholar 

  18. Mustard CA, Mayer T. Case-control study of exposure to medication and the risk of injurious falls requiring hospitalisation among nursing home residents.Am J Epidemiol 1997; 145: 738–45.

    PubMed  CAS  Google Scholar 

  19. Egger P, Duggleby S, Hobbs R, Fall C, Cooper C. Cigarette smoking and bone mineral density in the elderly.J Epid Community Health 1996; 50: 47–50.

    Article  CAS  Google Scholar 

  20. Khaw KT. Hormone replacement therapy again.Br Med J 1998; 316: 1842–4.

    CAS  Google Scholar 

  21. Meyer HE, Tverdal A, Falch JA. Risk factors for hip fracture in middle-aged Norwegian women and men.Am J Epidemiol 1993; 137: 1203–11.

    PubMed  CAS  Google Scholar 

  22. Gumming RG, Klineberg RJ. Case-control study of risk factors for hip fractures in the elderly.Am J Epidemiol 1994; 139: 493–503.

    Google Scholar 

  23. Cummings SR, Nevitt MC, Browner WS. Risk factors for hip fracture in white women. Study of osteoporotic fractures research group.New Engl J Med 1995; 332: 767–73.

    Article  PubMed  CAS  Google Scholar 

  24. Wolinsky FD, Fitzgerald JF. The risk of hip fracture among non-institutionalized older adults.J Gerontol 1994; 49: S165–75.

    PubMed  CAS  Google Scholar 

  25. White BL, Fisher WD, Laurin CA. Rate of mortality for elderly patients after fracture of the hip in the 1980s.J Bone Jt Surg 1987; 69: 1335–40.

    CAS  Google Scholar 

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Correspondence to P. Fitzpatrick.

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Fitzpatrick, P., Kirke, P.N., Daly, L. et al. Predictors of first hip fracture and mortality post fracture in older women. Ir J Med Sci 170, 49–53 (2001). https://doi.org/10.1007/BF03167722

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