For Older Women, Year Following Hip Fracture Can Be Especially Deadly

September 26, 2011


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By Amanda MacMillan

MONDAY, September 26, 2011 ( — Women age 65 and older who fracture a hip are much more likely to die from any cause during the following year than they would be if they had avoided injury, a new study suggests.

The increased risk of death associated with hip fractures was especially dramatic among younger women. In the 65- to 69-year-old age group, the odds of death were five times higher for women in a post-fracture year than they were for non-injured women of the same age, the study found.

Many of the 300,000 hip fractures that occur each year in the United States happen in postmenopausal women with the bone-thinning disease osteoporosis, typically after a fall or other accident. Researchers have already established that these fractures increase the risk of death, but they haven’t been able to rule out the possibility that women who fracture a hip are already at greater risk before their injury.

The new study, which carefully compared age-matched women with and without fractures, is the first to suggest a possible cause-and-effect relationship between hip fracture and death, says lead author Erin LeBlanc, MD, a researcher at Kaiser Permanente Northwest, a large nonprofit health plan in Portland, Ore.

“Before we might have assumed that sicker women are just more likely to get hip fractures,” she says. “But now we know that there is something about the hip fracture itself, and not an underlying condition, that is bringing on this increased risk of death.”

Dr. LeBlanc and her colleagues, whose findings appear in the Archives of Internal Medicine, tracked women in four states across the country between 1986 and 2005, as part of a larger study funded by the National Institutes of Health. From this pool of study participants, the researchers matched each of the 1,116 women who’d had hip fractures with four women of the same age who had not.

Overall, women who suffered a hip fracture had twice the odds of dying within one year of their injury than did their counterparts in the control group during the same year. Seventeen percent of the women who experienced a fracture died during the year, versus 8% in the control group. (In addition to matching the women by age, the researchers took into account body mass index, medical history, and several other risk factors for hip fracture.)

The top three causes of death—heart disease, stroke, and sepsis—were the same for both the fracture and control groups. But more than half of the deaths in the fracture group occurred within three months of the injury, and nearly three-quarters occurred within six months; this suggests that something about the surgery, hospital time, immobility, or rehabilitation required after a hip fracture makes women more vulnerable, says LeBlanc.

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