| Abstract: | Aims: The purposes of this study were to compare mortality rate of hip fracture patients with those without hip fracture, and to identify risk factors of death in hip fracture patients. Methods: This study is a 5-year cohort study in older adults with or without hip fracture in Taiwan. Data used for this study were from a case-control study of hip fracture in Taipei, conducted from 2004 to 2006. Hip fracture group included 228 patients with fist low-trauma hip fracture. A total of 497 individuals (215 from hospital; 282 from community) who were matched with hip fracture patients on age and sex were used as a comparison group. The vital status of all participants was verified through linking the mortality data provided by the Department of Health in Taiwan. During the follow-up, 144 deaths occurred. The average time of follow-up was 3.28 (SD=1.08) years. Baseline information collected for all 725 study participants from the case-control study include sociodemography, chronic diseases, lifestyle behaviors, geriatric syndromes, and functional measures. The Kaplan-Meier method was adopted to compare the survival curves of study partic-ipants with or without hip fracture. Cox proportional hazards regression models were used to estimate the hazard ratio of selected factors potentially associated with death. Results: The survival rates for each follow-up year were 87.3%, 81.1%, 74.1%, 66.7%, 65.8% in hip fracture group and 95.8%, 90.9%, 88.3%, 87.1%, 86.7% in non fracture group, respectively. The difference of overall survival between two groups by Kaplan-Meier analysis was statis-tically significant (Fig. 1). In the univariate analysis, six (age, gender, education level, BMI, cancer, physical function, handgrip strength, and peak flow rate) out of 23 factors were associated with death. Only BMI (lean vs. normal; HR=2.16, 95% CI:1.22–3.82) and peak flow rate (low vs. high; HR=5.01, 95% CI:1.44–17.48) were further identified to have independent effect on death in the multivariate analysis. Conclusions: Hip fracture patients have relatively higher mortality risk compared with older adults without fracture. The risk factors of death identified in our study may be further adopted to evaluate the mortality risk for hip fracture patients in both community and clinical setting. |
