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Archives of Osteoporosis

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01.12.2017 | Original Article

The impact of comorbidities on hip fracture mortality: a retrospective population-based cohort study

verfasst von: Mikk Jürisson, Mait Raag, Riina Kallikorm, Margus Lember, Anneli Uusküla

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2017

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Abstract

Summary

The impact of comorbidities on hip fracture-related excess mortality was assessed in a population-based age- and sex-matched cohort over 10 years. On average, only 1 out of 12 excess deaths over 10 years was related to pre-fracture life-threatening comorbidities. The presence of life-threatening comorbidities increased the excess risk of death after hip fracture.

Purpose

This work aimed to estimate the impact of pre-fracture comorbidities on the 10-year excess risk of all-cause death after hip fracture among Estonian men and women ≥ 50 years of age.

Methods

Retrospective, population-based 10-year study of people aged ≥ 50 in two cohorts: those with a hip fracture and an age- and sex-matched random sample from the national health insurance fund for comparison.

Results

We found that hip fracture was a strong independent risk factor for death. Upon adjustment for Charlson Comorbidities Index (CCI) score, the impact of life-threatening comorbidities on average hip fracture-related excess mortality was modest: only 8% of excess deaths over 10 years were related to comorbidities. Upon stratification by CCI groups, the excess risk of patients in CCI groups ≥ 3 and 1–2 exceeded that in the CCI 0 group over 5–7 years, indicating that in patients with life-threatening comorbidities, a hip fracture accelerates the chain of lethal events and brings deaths from other conditions forward. The impact of comorbidities was age- and time-dependent: in younger hip fracture patients, the comorbidities almost doubled the excess risk from a fracture in 10 years; in older patients, the effect was shorter and modest.

Conclusions

The presence of pre-fracture comorbidities increases the risk of excess death in hip fracture patients, but the comorbidity impact on aggregated excess mortality is modest.

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Titel: The impact of comorbidities on hip fracture mortality: a retrospective population-based cohort study
verfasst von: Mikk Jürisson
Mait Raag
Riina Kallikorm
Margus Lember
Anneli Uusküla
Publikationsdatum: 01.12.2017
Verlag: Springer London
Erschienen in: Archives of Osteoporosis / Ausgabe 1/2017
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-017-0370-z

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The impact of comorbidities on hip fracture mortality: a retrospective population-based cohort study

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