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Risk factors for subsequent hip fractures and fatality after an initial hip fracture in Korea: using nationwide
Jun-Il Yoo1, Ha-Young Kim2, Sunmee Jang3
1Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Insights
Men over 50 with hip fractures faced a higher fatality risk, but not an increased risk of subsequent fractures. This gender disparity in hip fracture outcomes may stem from men having more comorbid diseases.
Area of Science:
- Gerontology
- Orthopedics
- Epidemiology
Background:
- Hip fractures are a significant health concern in older adults, leading to substantial morbidity and mortality.
- Understanding risk factors for subsequent fractures and fatality is crucial for effective patient management.
Purpose of the Study:
- To investigate risk factors for subsequent hip fractures and fatality after an initial hip fracture in Korean adults aged 50 and over.
- To analyze gender-specific differences in hip fracture outcomes.
Main Methods:
- Utilized data from the Korean National Health Insurance Service database (2007-2016).
- Followed 16,915 patients aged ≥ 50 with a first hip fracture for 4 years.
- Employed Cox proportional hazards models to identify risk factors.
Main Results:
- Old age, renal disease, dementia, and Parkinson's disease increased the risk of subsequent hip fractures.
- The fatality rate after hip fracture was 1.6 times higher in men than women.
- Men exhibited higher prevalence of comorbidities like pneumonia, cerebrovascular disease, liver disease, renal disease, and malignancy.
Conclusions:
- Men over 50 with hip fractures have a higher risk of fatality, but not subsequent fractures, compared to women.
- The increased fatality risk in men is potentially linked to a greater burden of comorbid conditions.
Abstract:
In this study, the risk of fatality after hip fracture but not the risk of subsequent hip fractures was higher among men.
Introduction:
The purpose of this study was to analyze the risk factors for subsequent hip fractures and fatality after an initial hip fracture among Koreans older than 50 years of age using information in the national claims database.
Methods:
Our study was conducted using data from the Korean National Health Insurance Service database from 2007 to 2016. A total of 16,915 Korean patients aged ≥ 50 years with a first hip fracture in 2012 were followed for 4 years. Data on fracture, comorbidity, and prescription variables were retrieved from the national registry. The Cox proportional hazards model was used to identify the risk factors affecting subsequent hip fractures and fatality after the initial hip fracture.
Results:
A total of 952 patients had subsequent hip fractures, and 6793 patients died. The cumulative incidence rates were 1.3% after 1 year and 5.6% after 4 years. Old age, renal disease, dementia, and Parkinson's disease were associated with a higher risk of subsequent hip fractures. The fatality rate after the initial hip fracture was 1.6 times higher among men than among women. Certain risk factors for fatality, such as pneumonia after fracture, cerebrovascular disease, mild liver disease, renal disease, and malignancy, were more prevalent among men.
Conclusion:
During the study period, the risk of fatality after hip fracture but not the risk of subsequent hip fractures was higher among men. The gender difference in fatality might be explained by the larger burden of comorbid diseases among men.
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