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All major low-trauma fractures, not just hip and vertebral fractures, are associated with increased mortality after age 60.
Moreover, even minor fractures—those that do not involve the pelvis, distal femur, proximal tibia, proximal humerus, or three or more ribs—raise mortality risk in the oldest patients, reported Dr. Dana Bliuc of St. Vincent's Hospital, Sydney, and associates.
The researchers assessed outcomes after low-trauma fractures in a population-based study of 4,005 men and women aged 60 years and older who were followed from 1989 through 2007. This population was almost entirely white, so the findings may not be generalizable to other ethnic groups.
A total of 952 women and 343 men sustained at least one low-trauma fracture. Death followed closely in 461 of the women and 197 of the men.
At any age, mortality was consistently higher in subjects who had sustained fractures than in the general population. Mortality was 2–4 times higher than normal for both sexes after hip fracture, approximately 2 times higher after vertebral fracture, approximately 1.5 times higher after major fracture, and approximately 1.3 times higher after minor fracture.
Mortality remained elevated for a full 5 years before returning to normal levels following all fractures. The exception was hip fractures, in which mortality remained high for up to 10 years, the investigators said (JAMA 2009;301:513–21).
Patients who sustained one fracture were at twofold to fourfold higher risk for subsequent fractures, and mortality risk rose the same amount again for another 5 years with every subsequent fracture they sustained.
“Nonhip, nonvertebral fractures, [which are] generally not even considered in these types of studies, not only constituted almost 50% of the fractures studied, but also were associated with 29% of the premature mortality,” Dr. Bluic and colleagues wrote.
“This study was not specifically designed to examine the underlying causes of mortality; however, examination of death certificates suggested no difference between causes of death in the fracture group and the general population, with cardiac, respiratory, cerebrovascular, and malignancy being the major causes.
It still remains to be determined exactly what is responsible for the increased mortality following fracture,” they added.
This study was supported in part by grants from Amgen Inc., Merck Sharp & Dohme, Sanofi-Aventis, Servier Laboratories, and Novartis.
All major low-trauma fractures, not just hip and vertebral fractures, are associated with increased mortality after age 60.
Moreover, even minor fractures—those that do not involve the pelvis, distal femur, proximal tibia, proximal humerus, or three or more ribs—raise mortality risk in the oldest patients, reported Dr. Dana Bliuc of St. Vincent's Hospital, Sydney, and associates.
The researchers assessed outcomes after low-trauma fractures in a population-based study of 4,005 men and women aged 60 years and older who were followed from 1989 through 2007. This population was almost entirely white, so the findings may not be generalizable to other ethnic groups.
A total of 952 women and 343 men sustained at least one low-trauma fracture. Death followed closely in 461 of the women and 197 of the men.
At any age, mortality was consistently higher in subjects who had sustained fractures than in the general population. Mortality was 2–4 times higher than normal for both sexes after hip fracture, approximately 2 times higher after vertebral fracture, approximately 1.5 times higher after major fracture, and approximately 1.3 times higher after minor fracture.
Mortality remained elevated for a full 5 years before returning to normal levels following all fractures. The exception was hip fractures, in which mortality remained high for up to 10 years, the investigators said (JAMA 2009;301:513–21).
Patients who sustained one fracture were at twofold to fourfold higher risk for subsequent fractures, and mortality risk rose the same amount again for another 5 years with every subsequent fracture they sustained.
“Nonhip, nonvertebral fractures, [which are] generally not even considered in these types of studies, not only constituted almost 50% of the fractures studied, but also were associated with 29% of the premature mortality,” Dr. Bluic and colleagues wrote.
“This study was not specifically designed to examine the underlying causes of mortality; however, examination of death certificates suggested no difference between causes of death in the fracture group and the general population, with cardiac, respiratory, cerebrovascular, and malignancy being the major causes.
It still remains to be determined exactly what is responsible for the increased mortality following fracture,” they added.
This study was supported in part by grants from Amgen Inc., Merck Sharp & Dohme, Sanofi-Aventis, Servier Laboratories, and Novartis.
All major low-trauma fractures, not just hip and vertebral fractures, are associated with increased mortality after age 60.
Moreover, even minor fractures—those that do not involve the pelvis, distal femur, proximal tibia, proximal humerus, or three or more ribs—raise mortality risk in the oldest patients, reported Dr. Dana Bliuc of St. Vincent's Hospital, Sydney, and associates.
The researchers assessed outcomes after low-trauma fractures in a population-based study of 4,005 men and women aged 60 years and older who were followed from 1989 through 2007. This population was almost entirely white, so the findings may not be generalizable to other ethnic groups.
A total of 952 women and 343 men sustained at least one low-trauma fracture. Death followed closely in 461 of the women and 197 of the men.
At any age, mortality was consistently higher in subjects who had sustained fractures than in the general population. Mortality was 2–4 times higher than normal for both sexes after hip fracture, approximately 2 times higher after vertebral fracture, approximately 1.5 times higher after major fracture, and approximately 1.3 times higher after minor fracture.
Mortality remained elevated for a full 5 years before returning to normal levels following all fractures. The exception was hip fractures, in which mortality remained high for up to 10 years, the investigators said (JAMA 2009;301:513–21).
Patients who sustained one fracture were at twofold to fourfold higher risk for subsequent fractures, and mortality risk rose the same amount again for another 5 years with every subsequent fracture they sustained.
“Nonhip, nonvertebral fractures, [which are] generally not even considered in these types of studies, not only constituted almost 50% of the fractures studied, but also were associated with 29% of the premature mortality,” Dr. Bluic and colleagues wrote.
“This study was not specifically designed to examine the underlying causes of mortality; however, examination of death certificates suggested no difference between causes of death in the fracture group and the general population, with cardiac, respiratory, cerebrovascular, and malignancy being the major causes.
It still remains to be determined exactly what is responsible for the increased mortality following fracture,” they added.
This study was supported in part by grants from Amgen Inc., Merck Sharp & Dohme, Sanofi-Aventis, Servier Laboratories, and Novartis.