02707nas a2200337 4500008004100000022001400041245008100055210006900136260001300205300001200218490000700230520179100237653000902028653001902037653001102056653001802067653001902085653001802104653001102122653000902133653001402142653003302156653003202189653002102221653001702242653001802259100002102277700001902298700001702317856003502334 2006 eng d a0002-861400aAdjusted mortality after hip fracture: From the cardiovascular health study.0 aAdjusted mortality after hip fracture From the cardiovascular he c2006 Dec a1885-910 v543 a

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.

10aAged10aCohort Studies10aFemale10aHealth Status10aHealth Surveys10aHip Fractures10aHumans10aMale10aMortality10aMulticenter Studies as Topic10aProportional Hazards Models10aSex Distribution10aTime Factors10aUnited States1 aRobbins, John, A1 aBiggs, Mary, L1 aCauley, Jane uhttps://chs-nhlbi.org/node/934