Excess mortality following hip fracture: a systematic epidemiological review.
Level 3 - non-randomized controlled study
Systematic review of observational epidemiological cohort studies without meta-analysis.
PubMed 19421703 · doi:10.1007/s00198-009-0920-3
What was done
A systematic review was conducted to identify all published epidemiological studies reporting unadjusted and excess mortality rates following low-impact trauma hip fracture compared with non-hip fracture or community control populations.
What was found
A lack of consistent study design precluded formal meta-analysis or pooled analysis. Hip fracture was associated with excess mortality during the first post-fracture year ranging from 8.4% to 36% across identified studies. The relative risk of death was at least double that of age-matched controls, highest in the initial days to weeks, remained elevated for months to years, was higher in men than women regardless of age, and became less pronounced with advancing age.
Why it matters
This review establishes that excess mortality following fragility hip fracture is substantial and long-lasting, identifying men and the early post-fracture period as highest-risk targets for medical intervention.
Limits
The abstract does not state the number of studies or patients included. Heterogeneity in study designs prevented quantitative meta-analysis, and the role of specific pre-existing comorbidities is not quantified in the abstract text.
Cited by
- contradicts Approximately 50% of older individuals who suffer a hip fracture never regain full functional independence and die within two years.