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The impact of common co-morbidities (as measured using the Charlson index) on hip fracture risk in elderly men: a
1Primary Health Care Center, Eap Sardenya-Biomedical Resarch Institute Sant Pau (IIB Sant Pau), c/Sardenya 466, Barcelona, Spain.
Insights
Elderly men with diabetes, COPD, or dementia face a higher risk of hip fracture. A higher Charlson score also independently predicts increased hip fracture risk in this population.
Area of Science:
- Gerontology
- Epidemiology
- Public Health
Background:
- Hip fracture risk factors in elderly men remain incompletely understood.
- Identifying common comorbidities associated with increased hip fracture risk is crucial for preventative strategies.
Purpose of the Study:
- To investigate the impact of common comorbidities on hip fracture risk in elderly men.
- To identify specific comorbidities and composite scores that independently predict hip fractures.
Main Methods:
- Population-based cohort study utilizing the SIDIAP(Q) database (over 2 million individuals).
- Inclusion of men aged 65 and older, followed for approximately 3 years.
- Analysis using Poisson regression to assess the association between comorbidities (Charlson index) and hip fractures, adjusted for covariates.
Main Results:
- 186,171 men were observed, with 1,718 (0.92%) experiencing hip fractures.
- Diabetes, COPD, renal failure, HIV infection, dementia, and cerebrovascular disease were identified as independent predictors of hip fracture.
- A Charlson score of 3 or higher was significantly associated with increased hip fracture risk.
Conclusions:
- Common comorbidities such as diabetes, COPD, and cerebrovascular disease are independently linked to a higher risk of hip fracture in elderly men.
- A Charlson score of 3 or more indicates a substantially elevated risk (50% higher) for hip fracture in this demographic.
Unlabelled:
We used a large population-based health care database to determine the impact of common co-morbidities on hip fracture risk amongst elderly men. We demonstrated that diabetes, chronic obstructive pulmonary disease, renal failure, HIV infection, dementia, and cerebrovascular disease are independent predictors of hip fracture, as is a Charlson score of ≥ 3.
Introduction:
Risk factors for hip fractures in men are still unclear. We aimed to identify common co-morbidities (amongst those in the Charlson index) that confer an increased risk of hip fracture amongst elderly men.
Methods:
We conducted a population-based cohort study using data from the SIDIAP (Q) database. SIDIAP(Q) contains primary care and hospital inpatient records of a representative 30% of the population of Catalonia, Spain (>2 million people). All men aged ≥ 65 years registered on 1 January 2007 were followed up until 31 December 2009. Both exposure (co-morbidities in the Charlson index) and outcome (incident hip fractures) were ascertained using ICD codes. Poisson regression models were fitted to estimate the effect of (1) each individual co-morbidity and (2) the composite Charlson index score, on hip fracture risk, after adjustment for age, body mass index, smoking, alcohol drinking, and use of oral glucocorticoids.
Results:
We observed 186,171 men for a median (inter-quartile range) of 2.99 (2.37-2.99) years. In this time, 1,718 (0.92%) participants had a hip fracture. The following co-morbidities were independently associated with hip fractures: diabetes mellitus, chronic obstructive pulmonary disease (COPD), renal failure, HIV infection, dementia, and cerebrovascular disease. A Charlson score of ≥ 3 conferred an increased hip fracture risk.
Conclusion:
Common co-morbidities including diabetes, COPD, cerebrovascular disease, renal failure, and HIV infection are independently associated with an increased risk of hip fracture in elderly men. A Charlson score of 3 or more is associated with a 50% higher risk of hip fracture in this population.
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