BACKGROUND: We examined trends in hip fracture incidence in Denmark from 1980 to 2014, trends in subsequent 1-year mortality, and the prognostic impact of sex, age, and comorbidity. METHODS: This nationwide cohort study prospectively collected data from population-based Danish registries. We included 262,437 patients with incident hip fracture and assessed comorbidity using the Charlson Comorbidity Index (CCI). RESULTS: Despite slight increases in incidence rates (IRs) of hip fracture up to the mid-1990s, the annual IR decreased by 29% from 1980 to 2014 in women but remained stable in men. Decrease affected all age groups. IR decreased in patients without comorbidity but increased with increasing comorbidity (13% in patients with moderate and 510% in patients with very severe comorbidity). Adjusted mortality rate ratios (MRRs) following hip fracture in 2010-2014 compared with 1980-1984 were 0.68 (95% confidence interval [CI] = 0.65, 0.71) within 30 days and 0.63 (95% CI = 0.61, 0.66) within 31-365 days. The mortality decreased up to 40% irrespective of comorbidity. Compared with patients with no comorbidity, those with very severe comorbidity had adjusted MRRs of 2.48 (95% CI = 2.39, 2.56) and 2.81 (95% CI = 2.74, 2.88) within 30 days and 31-365 days post-hip fracture, respectively. CONCLUSIONS: Although the incidence rate of hip fracture increased substantially with increasing comorbidity, the following 1-year mortality decreased by 40% from 1980 through 2014 irrespective of sex, age, and comorbidity level, suggesting improvement in both treatment and rehabilitation of patients with hip fracture. Comorbidity burden was, however, a strong prognostic factor for 1-year mortality after hip fracture.
BACKGROUND: We examined trends in hip fracture incidence in Denmark from 1980 to 2014, trends in subsequent 1-year mortality, and the prognostic impact of sex, age, and comorbidity. METHODS: This nationwide cohort study prospectively collected data from population-based Danish registries. We included 262,437 patients with incident hip fracture and assessed comorbidity using the Charlson Comorbidity Index (CCI). RESULTS: Despite slight increases in incidence rates (IRs) of hip fracture up to the mid-1990s, the annual IR decreased by 29% from 1980 to 2014 in women but remained stable in men. Decrease affected all age groups. IR decreased in patients without comorbidity but increased with increasing comorbidity (13% in patients with moderate and 510% in patients with very severe comorbidity). Adjusted mortality rate ratios (MRRs) following hip fracture in 2010-2014 compared with 1980-1984 were 0.68 (95% confidence interval [CI] = 0.65, 0.71) within 30 days and 0.63 (95% CI = 0.61, 0.66) within 31-365 days. The mortality decreased up to 40% irrespective of comorbidity. Compared with patients with no comorbidity, those with very severe comorbidity had adjusted MRRs of 2.48 (95% CI = 2.39, 2.56) and 2.81 (95% CI = 2.74, 2.88) within 30 days and 31-365 days post-hip fracture, respectively. CONCLUSIONS: Although the incidence rate of hip fracture increased substantially with increasing comorbidity, the following 1-year mortality decreased by 40% from 1980 through 2014 irrespective of sex, age, and comorbidity level, suggesting improvement in both treatment and rehabilitation of patients with hip fracture. Comorbidity burden was, however, a strong prognostic factor for 1-year mortality after hip fracture.
Authors: Danielle S Abraham; Erik Barr; Glenn V Ostir; J Richard Hebel; Justine Golden; Ann L Gruber-Baldini; Jack M Guralnik; Marc C Hochberg; Denise L Orwig; Barbara Resnick; Jay S Magaziner Journal: Arch Phys Med Rehabil Date: 2018-11-02 Impact factor: 3.966
Authors: T Chevalley; M L Brandi; E Cavalier; N C Harvey; G Iolascon; C Cooper; D Hannouche; J-F Kaux; A Kurth; S Maggi; G Maier; K Papavasiliou; N Al-Daghri; M Sosa-Henríquez; N Suhm; U Tarantino; J-Y Reginster; R Rizzoli Journal: Osteoporos Int Date: 2021-05-20 Impact factor: 4.507
Authors: D Prieto-Alhambra; D Moral-Cuesta; A Palmer; I Aguado-Maestro; M F Bravo Bardaji; F Brañas; G Adrados Bueno; J R Caeiro-Rey; I Andrés Cano; M Barres-Carsi; L Gracia Delgado; M Salomó-Domènech; I Etxebarria-Foronda; B Llado Ferrer; S Mills; L Ezquerra Herrando; D Mifsut; L D R Evangelista; X Nogués; I Perez-Coto; J Martínez-Iñiguez Blasco; C Martín-Hernández; H Kessel; J Teixidor Serra; J Rodriguez Solis; O Torregrosa Suau; E Vaquero-Cervino; C Pablos Hernández; L Rodríguez Mañas; A Herrera; A Díez-Perez Journal: Arch Osteoporos Date: 2019-05-29 Impact factor: 2.617