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Falls and comorbidity: the pathway to fractures.

https://arctichealth.org/en/permalink/ahliterature105247
Source
Scand J Public Health. 2014 May;42(3):287-94
Publication Type
Article
Date
May-2014
Author
Terese Sara Høj Jørgensen
Annette Højmann Hansen
Marie Sahlberg
Gunnar H Gislason
Christian Torp-Pedersen
Charlotte Andersson
Ellen Holm
Author Affiliation
1Department of Geriatric Medicine, Nykøbing-Falster Hospital, Denmark.
Source
Scand J Public Health. 2014 May;42(3):287-94
Date
May-2014
Language
English
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Aged
Aged, 80 and over
Cause of Death - trends
Comorbidity
Databases, Factual
Dementia - epidemiology
Denmark - epidemiology
Depression - epidemiology
Diabetes Mellitus - epidemiology
Female
Heart Failure - epidemiology
Hip Fractures - epidemiology - mortality
Humans
Male
Myocardial Ischemia - epidemiology
Osteoporosis - epidemiology
Parkinson disease - epidemiology
Pulmonary Disease, Chronic Obstructive - epidemiology
Retrospective Studies
Risk factors
Shoulder Fractures - epidemiology - mortality
Stroke - epidemiology
Time Factors
Abstract
To compare nationwide time trends and mortality in hip and proximal humeral fractures; to explore associations between incidences of falls risk related comorbidities (FRICs) and incidence of fractures.
The study is a retrospective cohort study using nationwide Danish administrative registries from 2000 through 2009. Individuals aged 65 years or older who experienced a hip or a proximal humeral fracture were included. Incidence of hip and of proximal humeral fractures, incidence of FRICs (ischemic heart disease, COPD, dementia, depression, diabetes, heart failure, osteoporosis, Parkinson's disease and stroke) and incidence rate ratios (IRR) for fractures in patients with FRICs, and all-cause mortality up to 10 years after a hip or a proximal humeral fracture were analysed.
A total of 89,150 patients experienced hip fractures and 48,581 proximal humeral fractures. From 2000 through 2009, the incidence of hip fractures per 100,000 individuals declined by 198 (787 to 589, OR = 0.75, CI: 0.72-0.80) among males and by 483 (1758 to 1275, OR = 0.74, CI: 0.72-0.77) among females. Incidences of FRICs decreased. The absolute reduction in fractures was most pronounced for the age group above 75 years (2393 to 1884, OR = 0.81, CI: 0.78-0.83), but the relative reduction was more pronounced in the age group of 65-75 years old (496 to 342, OR = 0.70, CI: 0.66-0.74). IRRs for hip fractures and for proximal humeral fractures were significantly elevated in patients with FRICs.
The results suggest that the overall reduction in fractures can be explained by reduction in falls related comorbidity.
PubMed ID
24434943 View in PubMed
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Source
Osteoporos Int. 2005 Dec;16(12):1583-90
Publication Type
Article
Date
Dec-2005
Author
Farahmand Bahman Y
Michaëlsson Karl
Ahlbom Anders
Ljunghall Sverker
Baron John A
Author Affiliation
Institute of Environmental Medicine, Karolinska Institute, Box 210, 17177, Stockholm, Sweden. Bahman.Y.Farahmand@imm.ki.se
Source
Osteoporos Int. 2005 Dec;16(12):1583-90
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Cause of Death
Comorbidity
Female
Hip Fractures - epidemiology - mortality
Hospitalization
Humans
Middle Aged
Risk factors
Survival Analysis
Sweden - epidemiology
Time Factors
Abstract
Although it is known that overall mortality is increased after hip fracture, the influence of hip fracture risk factors on the subsequent mortality and cause of death has not been well studied. The objective of this study was to establish the survival after hip fracture in women and to assess the impact of comorbidity on mortality. We identified a complete population-based set of 2,245 incident hip fracture cases and 4,035 randomly selected population-based controls among women 50-81 years old in Sweden and followed these subjects for an average of 5 years through the Swedish National Inpatient and Cause-of-Death Registers. Information on factors related to hip fracture was obtained through linkage to hospital discharge data and through a mailed questionnaire. We studied excess mortality of hip fracture patients compared to controls using survival curves and proportional hazard regression models. During follow-up, 896 hip fracture patients (40%) and 516 (13%) controls died. The relative risk (RR) of death, adjusted for age and previous hospitalization for serious disease, was 2.3 (95% CI 2.0-2.5). Although the highest mortality risks were in the 1st 6 months post-fracture, RRs for fractures versus controls were increased for at least 6 years. Increased mortality was apparent both in those with evidence of comorbidity and those without. Hip fracture patients have a substantially increased risk of death that persists for at least 6 years post-fracture. The relative excess mortality is independent of comorbidity and known hip fracture risk factors.
PubMed ID
16217590 View in PubMed
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