Chang · Injury 2026 · Retrospective nationwide cohort study · n=315,808

Comparison of life expectancy and loss of life expectancy in fall-risk populations with hip and vertebral fractures: A 10-year nationwide cohort study.

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Level 3 - non-randomized controlled study

Retrospective nationwide cohort study using administrative database records.

PubMed 42025401 · doi:10.1016/j.injury.2026.113274 · record verified 2026-08-31

What was done

Researchers identified patients with hip fractures (n = 214,077; mean age 77.1 years) and vertebral fractures (n = 101,731; mean age 73.4 years) in Taiwan's National Health Insurance Research Database (NHIRD) using ICD-9 and ICD-10 codes. Kaplan-Meier and Monte Carlo methods were applied to estimate survival functions compared with a reference population, and extrapolation beyond the follow-up period was conducted to estimate lifetime life expectancy.

What was found

Women made up the majority of both cohorts. The estimated lifetime life expectancy was 7.9 years for patients with hip fractures and 11.9 years for patients with vertebral fractures. In both fracture cohorts, patients with a history of stroke experienced the greatest loss of life expectancy.

Why it matters

This study provides population-based estimates of long-term survival after major fragility fractures and identifies individuals with a history of stroke as being at particularly high risk for shortened life expectancy following a fracture.

Limits

The study relied on administrative claims data, which are vulnerable to miscoding and lack granular clinical detail such as fracture severity, bone mineral density, lifestyle factors, or functional recovery. Lifetime survival estimates depended on mathematical extrapolation beyond the empirical follow-up period, and results from Taiwan may not generalize to other healthcare settings or populations.

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