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Proximal, not distal fractures, associated with premature mortality in older men, women

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SAN FRANCISCO — Although research presented here at the American College of Rheumatology Annual Meeting showed proximal fractures were associated with premature mortality of older men and women, distal fractures were not associated with this outcome.

“Health professionals have been aware for some time that having a hip fracture when you are older increases your risk of dying in 1 [year] to 2 years after the fracture, but we have not been so aware that other fractures could increase this risk as well,” Lyn March, MD, PhD, professor of rheumatology and musculoskeletal epidemiology at the Kolling Institute of Bone and Joint Research at the University of Sydney Liggins and Sydney’s Royal North Shore Hospital, said.

March and colleagues identified fracture events in the 45 & Up Study, a population-based cohort of 125,174 women and 113,499 men, and linked data to the Admitted Patient Collection that includes hospital admission data in New South Wales, the Emergency Department Data Collection and to the Registry of Births, Marriages and Deaths using ICD-9, ICD-10, and other diagnostic information and procedure codes. The mean age of participants was 63 years, with a mean follow-up of 5.7 years.

The investigators identified 14,827 fractures in 9,145 women and 5,682 men. They found 15,621 deaths in 5,604 women and 10,017 men.

Cox proportional hazards models revealed a higher absolute mortality rate in men at 15.7 per 1,000 person-years compared with women who had a rate of 7.9 per 1,000 person-years. Men had a risk of 33 per 1,000 person-years for increased mortality in the presence of a fracture, while women had a risk of 19 per 1,000 person years in the presence of a fracture. Further analysis showed increased mortality was observed for all proximal fractures, but no association was seen with distal fractures. - by Shirley Pulawski

Reference:

March L, et al. Paper #3173. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosures:

The researchers report no relevant financial disclosures.