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Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project

Katsoulis, M; Benetou, V; Karapetyan, T; Feskanich, D; Grodstein, F; Pettersson-Kymmer, U; Eriksson, S; ... Trichopoulou, A; + view all (2017) Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project. Journal of Internal Medicine , 281 (3) pp. 300-310. 10.1111/joim.12586. Green open access

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Abstract

Background Hip fractures are associated with diminished quality of life and survival especially amongst the elderly. Objective All-cause mortality after hip fracture was investigated to assess its magnitude. Methods A total of 122 808 participants from eight cohorts in Europe and the USA were followed up for a mean of 12.6 years, accumulating 4273 incident hip fractures and 27 999 deaths. Incident hip fractures were assessed through telephone interviews/questionnaires or national inpatient/fracture registries, and causes of death were verified with death certificates. Cox proportional hazards models and the time-dependent variable methodology were used to assess the association between hip fracture and mortality and its magnitude at different time intervals after the injury in each cohort. We obtained the effect estimates through a random-effects meta-analysis. Results Hip fracture was positively associated with increased all-cause mortality; the hazard ratio (HR) in the fully adjusted model was 2.12, 95% confidence interval (CI) 1.76–2.57, after adjusting for potential confounders. This association was stronger amongst men [HR: 2.39, 95% CI: 1.72–3.31] than amongst women [HR: 1.92, 95% CI: 1.54–2.39], although this difference was not significant. Mortality was higher during the first year after the hip fracture [HR: 2.78, 95% CI: 2.12–3.64], but it remained elevated without major fluctuations after longer time since hip fracture [HR (95% CI): 1.89 (1.50–2.37) after 1–4 years; 2.15 (1.81–2.55) after 4–8 years; 1.79 (1.57–2.05) after 8 or more years]. Conclusion In this large population-based sample of older persons across eight cohorts, hip fracture was associated with excess short- and long-term all-cause mortality in both sexes.

Type: Article
Title: Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/joim.12586
Publisher version: http://doi.org/10.1111/joim.12586
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, ageing, bone, CHANCES, hip fracture, mortality, OLDER WOMEN, PROSPECTIVE COHORT, FUNCTIONAL STATUS, RISK-FACTORS, SURVIVAL, MEN, METAANALYSIS, VALIDATION, DISEASE, DESIGN
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Health Informatics > Clinical Epidemiology
URI: https://discovery.ucl.ac.uk/id/eprint/1543476
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