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Rates of hip fracture, subsequent 1-year mortality differ by race
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The incidence of hip fracture is highest among white men and lowest among Asian men, with Asian men also experiencing lower 1-year mortality risk than white, Hispanic and black men, according to a retrospective database analysis.
“Our study contributes to the growing recognition of racial/ethnic differences in postfracture mortality,” Lucy H. Liu, MD, MPH, of the department of medicine at Kaiser Permanente Oakland Medical Center, California, and colleagues wrote. “Similar to women, 1-year mortality rates following hip fracture were lower in Asian men, but morality rates were comparable for white, black and Hispanic men.”
Using electronic records from the Kaiser Permanente Northern California health system, Liu and colleagues analyzed data from men aged at least 50 years with a principal hospital discharge diagnosis of proximal femur fracture between 2000 and 2010. Demographic data, including race, were obtained from administrative databases. All-cause mortality was determined up to 12 months after hip fracture. Researchers used logistic regression analyses to examine the independent association of race and 1-year postfracture mortality.
From 2000 to 2010, 6,247 men sustained a hip fracture; mean age at time of fracture was 79 years and 81.4% were white. Average annual age-adjusted incidence of hip fracture was 127 per 100,000 men.
Researchers observed racial differences in contemporary hip fracture rates. In 2010, the age-adjusted incidence of hip fracture was highest for white men at 137 per 100,000 men, followed by Hispanic men (98 per 100,000 men), black men (80 per 100,000 men) and Asian men (45 per 100,000 men).
Of the men who sustained a hip fracture, nearly one-third died in the subsequent 12 months, according to researchers. All-cause mortality rates rose from 11.1% at 1 month to 32.9% at 12 months, with mortality increasing substantially with age.
Researchers also observed racial differences in postfracture mortality, with a lower 1-year mortality rate for Asian men (23.1%) vs. white (33.7%), black (32.4%) and Hispanic men (31.1%), although Asian men were younger at the time of fracture than other racial groups. After adjusting for age, lower mortality risk persisted for Asian men vs. white men (adjusted OR = 0.65; 95% CI, 0.47-0.88).
“Compared with men of white race, Asian men had two-thirds lower hip fracture incidence and one-third lower mortality risk at 1 year following hip fracture,” the researchers wrote. “As the aging population becomes increasingly diverse, a greater understanding of the cultural, social and health-related factors affecting fracture outcomes in health care settings will optimize the targeting of multidisciplinary efforts to reduce morbidity and mortality following hip fracture in men.” – by Regina Schaffer
Disclosures: One author reports she received research funding from Amgen; another author reports she received research funding from Amgen and Sanofi. The other authors report no relevant financial disclosures.
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