@article {934, title = {Adjusted mortality after hip fracture: From the cardiovascular health study.}, journal = {J Am Geriatr Soc}, volume = {54}, year = {2006}, month = {2006 Dec}, pages = {1885-91}, abstract = {

OBJECTIVES: To estimate the risk of death associated with hip fracture (HFx), stratifying by sex and time since fracture.

DESIGN: Prospective cohort study compared participants with and without hip fracture, matched on sex, age, race, recruitment period, and time since enrollment.

SETTING: The Cardiovascular Health Study, a more-than-15-year longitudinal study of 5,888 older individuals from four U.S. sites.

PARTICIPANTS: Three hundred seventy-nine individuals with HFx were compared with 1,134 without HFx.

MEASUREMENTS: Extended Cox models were used to estimate mortality hazard ratios (HRs) for different periods after fracture, adjusting for prefracture health.

RESULTS: Age- and race-adjusted excess mortality was 9\% in women and 24\% in men 1 year after fracture, and 24\% in women and 26\% men 5 years postfracture. Multivariable-adjusted HRs of mortality associated with HFx in women were 7.1 (95\% confidence interval (CI) = 2.3-21.5), 2.1 (95\% CI = 1.0-4.1), 1.4 (95\% CI = 1.1-2.0), and 1.0 (95\% CI = 0.6-1.5) for 0 to 1 months, 2 to 6 months, 7 months to 4 years, and 5 to 8 years, respectively, after index date. In men, respective HRs for the same time periods were 39.9 (95\% CI = 5.2-308.7), 3.8 (95\% CI = 1.4-10.3), 1.1 (95\% CI = 0.7-1.8), and 1.0 (95\% CI = 0.3-2.7). HRs adjusted for age and race were 20\% to 40\% higher.

CONCLUSION: The risk of mortality was highest in the first 6 months after HFx. In men, the risk of death approximated that of men without HFx after 6 months; in women, a moderately greater risk persisted through the fourth year. Although the mortality pattern was different in women and men, excess mortality 5 years postfracture was similar for both sexes.

}, keywords = {Aged, Cohort Studies, Female, Health Status, Health Surveys, Hip Fractures, Humans, Male, Mortality, Multicenter Studies as Topic, Proportional Hazards Models, Sex Distribution, Time Factors, United States}, issn = {0002-8614}, doi = {10.1111/j.1532-5415.2006.00985.x}, author = {Robbins, John A and Biggs, Mary L and Cauley, Jane} }