Broken bones among older people increase risk of death for up to 10 years: Femur, pelvic fractures pose similar risk as hip fractures

Broken bones among older people increase their risk of death for up to 10 years, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Older people with broken bones face a higher risk of death, and that risk can stay elevated for years. Hip fractures are known to increase the mortality risk among older people, and this is the first study to identify how long this risk lasts for different fractures. Non-hip fractures contribute to more than two-thirds of all fragility fractures and can include fractures of the femur, pelvis, clavicle or lower leg.

“A fracture is the starting point for much wider health issues that persist long after the fracture has healed and can ultimately result in earlier death,” said Jacqueline Center, M.B.B.S., Ph.D., of the Garvan Institute of Medical Research in Sydney, Australia. “We tracked the increased risk of death for fractures in different bones and found that they vary. The heightened risk can last for over a decade after a hip fracture, and for most other fractures (apart from distal or minor fractures), the increased risk is for about five years.”

This nationwide, registry-based follow-up study included all individuals in Denmark over the age of 50 who first experienced fragility fractures in 2001 and were followed up to 10 years for their mortality risk.

In the year after breaking a hip, men faced a 33 percent higher risk of death and women had a 20 percent higher risk. For femur or pelvic fractures, the one-year excess mortality was between 20 percent and 25 percent. A significant risk of death was still observed 10 years after a person broke a hip, and approximately five years following non-hip fractures.

“Our findings emphasize just how crucial early intervention is,” Center said. “We need to understand the risk of breaking a bone before the fracture happens and treat that individual accordingly. While intervention after the first fracture is critical, we also need to diagnose those at risk of breaking bones before these major health impacts have occurred.”

Other authors of the study include: Thach Tran and Dana Bliuc of the Garvan Institute of Medical Research; Louise Hansen of Aalborg University in Aalborg East, Denmark; Bo Abrahamsen of Holbæk Hospital in Holbæk, Denmark, and University of Southern Denmark in Odense, Denmark; Joop van den Bergh of Maastricht University Medical Center in Maastricht, The Netherlands, and VieCuri Medical Centre of Noord-Limburgm in Venlo, The Netherlands; John A. Eisman of the Garvan Institute of Medical Research, St Vincent’s Hospital, University of New South Wales, and University of Notre Dame Australia in Sydney, Australia; Tineke van Geel of Maastricht University; Piet Geusens of Maastricht University Medical Center and University Hasselt in Hasselt, Belgium; Peter Vestergaard of Aalborg University and Aalborg University Hospital; and Tuan V. Nguyen of the Garvan Institute of Medical Research and University of New South Wales.

The study received support from the National Health Medical Research Council Australia.

The study, “Persistence of Excess Mortality Following Individual Non-Hip Fractures: A Relative Survival Analysis,” will be published online, ahead of print.

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