Hip Fractures Increase Risk of Early Death for Elderly Women

Risk of death within one year after fracture doubles for women over 65—and increases five-fold for women 65–69

Elderly women who break a hip have a higher risk of early death, according to the results of a Kaiser Permanente Center for Health Research study published in the Archives of Internal Medicine.

A study team led by Erin LeBlanc, MD, MPH, analyzed nearly 20 years of data from the Study of Osteoporotic Fractures (SOF), a community-based, multi-site cohort of 5,580 women. Dr. LeBlanc and her co-investigator, Teresa Hillier, MD, MS, sought to better understand how age and underlying health status affect the risk of mortality after hip fracture.

The team’s findings show that among women over the age of 65 who suffer a hip fracture, the risk of death in the first year after the fracture doubles compared to similarly aged women with no hip fracture. When this large group is stratified by age bracket and health status, intriguing statistics emerge:

  • While the risk of mortality in the first year after hip fracture doubles for all women over 65, that risk increases five-fold for women age 65–69.
  • Women aged 65–69 continued to have a higher mortality risk for up to 10 years after hip fracture, while women over 70 returned to their previous risk levels after one year.
  • As a group, women 80 and over experienced no increased mortality risk after hip fracture, but women 80 and over who were in good or excellent health before the fracture experienced a nearly three-fold increase in risk of death in the first year.

Thanks to the large size and extensive follow-up of the SOF cohort, Dr. LeBlanc and her colleagues were able to tease apart the factors that may increase mortality: the fracture itself, the age of the women, and the women’s pre-fracture health status. The increased mortality risk in women under age 70 and in healthy women age 80 and over suggests that hip fracture itself presents significant risk, independent of underlying health status.

Hip fractures are already a major cause of concern for older people and their health care providers. They are expected to become even more common as the population ages. This research advances our understanding of who stands to benefit most from preventive measures and post-fracture interventions.

You can read the full paper online in Archives of Internal Medicine.

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