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Mortality After Hip Fracture in Austria 2008–2011

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Abstract

Osteoporosis-related hip fractures represent a substantial cause of mortality and morbidity in industrialized countries like Austria. Identification of groups at high risk for mortality after hip fracture is crucial for health policy decisions. To determine in-hospital, long-term, and excess mortality after osteoporosis-related hip fracture in Austrian patients, we conducted a retrospective cohort analysis of pseudonymized invoice data from Austrian social insurance authorities covering roughly 98 % of the entire population. The data set included 31,668 subjects aged 50 years and above sustaining a hip fracture between July 2008 and December 2010 with follow-up until June 2011, and an age-, gender-, and regionally matched control population without hip fractures (56,320 subjects). Kaplan–Meier and Cox hazard regression analyses served to determine unadjusted and adjusted mortality rates: Unadjusted all-cause 1-year mortality amounted to 20.2 % (95 % CI: 19.7–20.7 %). Males had significantly higher long-term, in-hospital, and excess mortality rates than females, but younger males exhibited lower excess mortality than their female counterparts. Advanced age correlated with increased long-term and in-hospital mortality, but lower excess mortality. Excess mortality, particularly in males, was highest in the first 6 months after hip fracture, but remained statistically significantly elevated throughout the observation period of 3 years. Longer hospital stay per fracture was correlated with mortality reduction in older patients and in patients with more subsequent fractures. In conclusion, more efforts are needed to identify causes and effectively prevent excess mortality especially in male osteoporosis patients.

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Acknowledgments

We thank Katrin Danninger (Oberösterreichische Gebietskrankenkasse), Alexandra Ferdin (Versicherungsanstalt öffentlich Bediensteter), Jana Fischer (Niederösterreichische Gebietskrankenkasse), Peter Haubenberger (Sozialversicherungsanstalt der Gewerblichen Wirtschaft), Michael Hueber (Versicherungsanstalt für Eisenbahnen und Bergbau), Renato Kasseroller (Salzburger Gebietskrankenkasse), Claudia Kastelic (Sozialversicherungsanstalt der Bauern), Tobias Lingenhöle (Vorarlberger Gebietskrankenkasse), Ursula Riess (Kärntner Gebietskrankenkasse), Marianne Schmid (Steiermärkische Gebietskrankenkasse), Cornelia Siess (Wiener Gebietskrankenkasse), and Norbert Thiemann (Tiroler Gebietskrankenkasse) from the Austrian social insurance authorities for provision of the data.

Human and Animal Rights and Informed Consent

The local Ethics Committee approved the study which was performed according to the Declaration of Helsinki.

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Authors and Affiliations

  1. Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of the WGKK and AUVA Trauma Center, 1st Medical Department at Hanusch Hospital, Heinrich Collin Str. 30, 1140, Vienna, Austria

    Wolfgang Brozek, Jochen Zwerina, Daniela Kritsch, Klaus Klaushofer & Elisabeth Zwettler

  2. Sickness Fund Burgenland, Burgenländische Gebietskrankenkasse, Esterhazyplatz 3, 7000, Eisenstadt, Austria

    Berthold Reichardt

  3. Clinical Department of General Anesthesia and Intensive Care Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Oliver Kimberger

  4. Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria

    Hans Peter Dimai

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  1. Wolfgang Brozek
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  2. Berthold Reichardt
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  3. Oliver Kimberger
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  4. Jochen Zwerina
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  5. Hans Peter Dimai
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  6. Daniela Kritsch
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  7. Klaus Klaushofer
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  8. Elisabeth Zwettler
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Correspondence to Wolfgang Brozek.

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The authors declare that they have no conflict of interest.

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Brozek, W., Reichardt, B., Kimberger, O. et al. Mortality After Hip Fracture in Austria 2008–2011. Calcif Tissue Int 95, 257–266 (2014). https://doi.org/10.1007/s00223-014-9889-9

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  • DOI: https://doi.org/10.1007/s00223-014-9889-9

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