Hip fracture incidence and post-fracture mortality in Victoria, Australia: a state-wide cohort study

Miriam T.Y. Leung; Clara Marquina; Justin P. Turner; Jenni Ilomaki; Tim Tran; J. Simon Bell

doi:10.1007/s11657-023-01254-6

Hip fracture incidence and post-fracture mortality in Victoria, Australia: a state-wide cohort study

Miriam T.Y. Leung, Clara Marquina, Justin P. Turner, Jenni Ilomaki, Tim Tran, J. Simon Bell

Research output: Contribution to journal › Article › Research › peer-review

11 Citations (Scopus)

Abstract

Summary : Hip fractures are a major public health concern. Number of hip fractures cases increased by 20% from 2012 to 2018. Factors associated with post-fracture mortality included men, those who are frail, living in a non-metropolitan region, or residing in a residential aged care facility. Our results are useful for planning healthcare interventions.

Purpose: Hip fractures are a major public health concern in Australia. Data on hip fracture incidence and mortality are needed to plan and evaluate healthcare interventions. The aims of the study were to investigate (1) the time-trend in absolute number and incidence of first hip fractures, and (2) factors associated with mortality following first hip fractures in Victoria, Australia.

Methods: A state-wide cohort study of all patients aged ≥ 50 years admitted to a Victorian hospital for first hip fracture between July 2012 and June 2018. Annual age-standardized incidence rates were calculated using population data from Australian Bureau of Statistics. Multivariate negative binomial regression was used to investigate factors associated with post-fracture mortality.

Results: Overall, 31,578 patients had a first hip fracture, of whom two-thirds were women and 47% were ≥ 85 years old. Absolute annual numbers of first hip fractures increased by 20%. There was no significant change in age- and sex-adjusted incidence. In total, 8% died within 30 days and 25% within 1 year. Factors associated with 30-day mortality included age (≥ 85 years old versus 50–64 years old, mortality rate ratio [MRR] 8.05, 95% confidence interval [CI] 5.86–11.33), men (MRR 2.11, 95% CI 1.88–2.37), higher Hospital Frailty Risk Scores (high frailty versus no frailty, MRR 3.46, 95% CI 2.66–4.50), admission from a residential aged care facility (RACF) (MRR 2.28, 95% CI 1.85–2.82), and residing in a non-metropolitan region (MRR 1.22, 95% CI 1.09–1.38). The same factors were associated with 1-year mortality.

Conclusion: The absolute increase in hip fractures highlights the need for interventions to reduce fracture risk, especially for those at higher risk of post-fracture mortality, including men and those who are frail, living in a non-metropolitan region, or residing in a RACF.

Original language	English
Article number	56
Number of pages	9
Journal	Archives of Osteoporosis
Volume	18
Issue number	1
DOIs	https://doi.org/10.1007/s11657-023-01254-6
Publication status	Published - 29 Apr 2023

Keywords

Frailty
Hip fracture
Incidence
Mortality
Risk factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s11657-023-01254-6Licence: CC BY

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@article{01f7b479854e470bb74f4179e4cf76b7,

title = "Hip fracture incidence and post-fracture mortality in Victoria, Australia: a state-wide cohort study",

abstract = "Summary : Hip fractures are a major public health concern. Number of hip fractures cases increased by 20% from 2012 to 2018. Factors associated with post-fracture mortality included men, those who are frail, living in a non-metropolitan region, or residing in a residential aged care facility. Our results are useful for planning healthcare interventions. Purpose: Hip fractures are a major public health concern in Australia. Data on hip fracture incidence and mortality are needed to plan and evaluate healthcare interventions. The aims of the study were to investigate (1) the time-trend in absolute number and incidence of first hip fractures, and (2) factors associated with mortality following first hip fractures in Victoria, Australia. Methods: A state-wide cohort study of all patients aged ≥ 50 years admitted to a Victorian hospital for first hip fracture between July 2012 and June 2018. Annual age-standardized incidence rates were calculated using population data from Australian Bureau of Statistics. Multivariate negative binomial regression was used to investigate factors associated with post-fracture mortality. Results: Overall, 31,578 patients had a first hip fracture, of whom two-thirds were women and 47% were ≥ 85 years old. Absolute annual numbers of first hip fractures increased by 20%. There was no significant change in age- and sex-adjusted incidence. In total, 8% died within 30 days and 25% within 1 year. Factors associated with 30-day mortality included age (≥ 85 years old versus 50–64 years old, mortality rate ratio [MRR] 8.05, 95% confidence interval [CI] 5.86–11.33), men (MRR 2.11, 95% CI 1.88–2.37), higher Hospital Frailty Risk Scores (high frailty versus no frailty, MRR 3.46, 95% CI 2.66–4.50), admission from a residential aged care facility (RACF) (MRR 2.28, 95% CI 1.85–2.82), and residing in a non-metropolitan region (MRR 1.22, 95% CI 1.09–1.38). The same factors were associated with 1-year mortality. Conclusion: The absolute increase in hip fractures highlights the need for interventions to reduce fracture risk, especially for those at higher risk of post-fracture mortality, including men and those who are frail, living in a non-metropolitan region, or residing in a RACF.",

keywords = "Frailty, Hip fracture, Incidence, Mortality, Risk factors",

author = "Leung, {Miriam T.Y.} and Clara Marquina and Turner, {Justin P.} and Jenni Ilomaki and Tim Tran and Bell, {J. Simon}",

note = "Funding Information: The authors gratefully acknowledge Centre for Victoria Data Linkage and Australian Institute of Health and Welfare for provision of the data. The authors gratefully acknowledge Professor Ian Cameron, University of Sydney, for his comments and feedback on the manuscript. Funding Information: Open Access funding enabled and organized by CAUL and its Member Institutions The authors gratefully acknowledge funding provided by the Dementia Australia Research Foundation – Yulgilbar Innovation Grant. ML is supported by Australian Government Research Training Scholarship. JSB is supported by a National Health and Medical Research Council (NHMRC) Dementia Leadership Fellowship. Funding Information: JI has received grant or consulting funds from the National Health and Medical Research Council, Medical Research Future Fund, Dementia Australia Research Foundation, Yulgilbar Foundation, National Breast Cancer Foundation, AstraZeneca, and Amgen unrelated to this work. JSB has received grant funding or consulting funds from the National Health and Medical Research Council, Medical Research Future Fund, Victorian Government Department of Health and Human Services, Dementia Australia Research Foundation, Yulgilbar Foundation, Aged Care Quality and Safety Commission, Dementia Centre for Research Collaboration, Pharmaceutical Society of Australia, Society of Hospital Pharmacists of Australia, GlaxoSmithKline Supported Studies Programme, Amgen, and several aged care provider organizations unrelated to this work. All grants and consulting funds were paid to the employing institution. Other authors have no conflicts of interests to declare. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = apr,

day = "29",

doi = "10.1007/s11657-023-01254-6",

language = "English",

volume = "18",

journal = "Archives of Osteoporosis",

issn = "1862-3514",

publisher = "Springer",

number = "1",

}

TY - JOUR

T1 - Hip fracture incidence and post-fracture mortality in Victoria, Australia

T2 - a state-wide cohort study

AU - Leung, Miriam T.Y.

AU - Marquina, Clara

AU - Turner, Justin P.

AU - Ilomaki, Jenni

AU - Tran, Tim

AU - Bell, J. Simon

N1 - Funding Information: The authors gratefully acknowledge Centre for Victoria Data Linkage and Australian Institute of Health and Welfare for provision of the data. The authors gratefully acknowledge Professor Ian Cameron, University of Sydney, for his comments and feedback on the manuscript. Funding Information: Open Access funding enabled and organized by CAUL and its Member Institutions The authors gratefully acknowledge funding provided by the Dementia Australia Research Foundation – Yulgilbar Innovation Grant. ML is supported by Australian Government Research Training Scholarship. JSB is supported by a National Health and Medical Research Council (NHMRC) Dementia Leadership Fellowship. Funding Information: JI has received grant or consulting funds from the National Health and Medical Research Council, Medical Research Future Fund, Dementia Australia Research Foundation, Yulgilbar Foundation, National Breast Cancer Foundation, AstraZeneca, and Amgen unrelated to this work. JSB has received grant funding or consulting funds from the National Health and Medical Research Council, Medical Research Future Fund, Victorian Government Department of Health and Human Services, Dementia Australia Research Foundation, Yulgilbar Foundation, Aged Care Quality and Safety Commission, Dementia Centre for Research Collaboration, Pharmaceutical Society of Australia, Society of Hospital Pharmacists of Australia, GlaxoSmithKline Supported Studies Programme, Amgen, and several aged care provider organizations unrelated to this work. All grants and consulting funds were paid to the employing institution. Other authors have no conflicts of interests to declare. Publisher Copyright: © 2023, The Author(s).

PY - 2023/4/29

Y1 - 2023/4/29

N2 - Summary : Hip fractures are a major public health concern. Number of hip fractures cases increased by 20% from 2012 to 2018. Factors associated with post-fracture mortality included men, those who are frail, living in a non-metropolitan region, or residing in a residential aged care facility. Our results are useful for planning healthcare interventions. Purpose: Hip fractures are a major public health concern in Australia. Data on hip fracture incidence and mortality are needed to plan and evaluate healthcare interventions. The aims of the study were to investigate (1) the time-trend in absolute number and incidence of first hip fractures, and (2) factors associated with mortality following first hip fractures in Victoria, Australia. Methods: A state-wide cohort study of all patients aged ≥ 50 years admitted to a Victorian hospital for first hip fracture between July 2012 and June 2018. Annual age-standardized incidence rates were calculated using population data from Australian Bureau of Statistics. Multivariate negative binomial regression was used to investigate factors associated with post-fracture mortality. Results: Overall, 31,578 patients had a first hip fracture, of whom two-thirds were women and 47% were ≥ 85 years old. Absolute annual numbers of first hip fractures increased by 20%. There was no significant change in age- and sex-adjusted incidence. In total, 8% died within 30 days and 25% within 1 year. Factors associated with 30-day mortality included age (≥ 85 years old versus 50–64 years old, mortality rate ratio [MRR] 8.05, 95% confidence interval [CI] 5.86–11.33), men (MRR 2.11, 95% CI 1.88–2.37), higher Hospital Frailty Risk Scores (high frailty versus no frailty, MRR 3.46, 95% CI 2.66–4.50), admission from a residential aged care facility (RACF) (MRR 2.28, 95% CI 1.85–2.82), and residing in a non-metropolitan region (MRR 1.22, 95% CI 1.09–1.38). The same factors were associated with 1-year mortality. Conclusion: The absolute increase in hip fractures highlights the need for interventions to reduce fracture risk, especially for those at higher risk of post-fracture mortality, including men and those who are frail, living in a non-metropolitan region, or residing in a RACF.

AB - Summary : Hip fractures are a major public health concern. Number of hip fractures cases increased by 20% from 2012 to 2018. Factors associated with post-fracture mortality included men, those who are frail, living in a non-metropolitan region, or residing in a residential aged care facility. Our results are useful for planning healthcare interventions. Purpose: Hip fractures are a major public health concern in Australia. Data on hip fracture incidence and mortality are needed to plan and evaluate healthcare interventions. The aims of the study were to investigate (1) the time-trend in absolute number and incidence of first hip fractures, and (2) factors associated with mortality following first hip fractures in Victoria, Australia. Methods: A state-wide cohort study of all patients aged ≥ 50 years admitted to a Victorian hospital for first hip fracture between July 2012 and June 2018. Annual age-standardized incidence rates were calculated using population data from Australian Bureau of Statistics. Multivariate negative binomial regression was used to investigate factors associated with post-fracture mortality. Results: Overall, 31,578 patients had a first hip fracture, of whom two-thirds were women and 47% were ≥ 85 years old. Absolute annual numbers of first hip fractures increased by 20%. There was no significant change in age- and sex-adjusted incidence. In total, 8% died within 30 days and 25% within 1 year. Factors associated with 30-day mortality included age (≥ 85 years old versus 50–64 years old, mortality rate ratio [MRR] 8.05, 95% confidence interval [CI] 5.86–11.33), men (MRR 2.11, 95% CI 1.88–2.37), higher Hospital Frailty Risk Scores (high frailty versus no frailty, MRR 3.46, 95% CI 2.66–4.50), admission from a residential aged care facility (RACF) (MRR 2.28, 95% CI 1.85–2.82), and residing in a non-metropolitan region (MRR 1.22, 95% CI 1.09–1.38). The same factors were associated with 1-year mortality. Conclusion: The absolute increase in hip fractures highlights the need for interventions to reduce fracture risk, especially for those at higher risk of post-fracture mortality, including men and those who are frail, living in a non-metropolitan region, or residing in a RACF.

KW - Frailty

KW - Hip fracture

KW - Incidence

KW - Mortality

KW - Risk factors

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U2 - 10.1007/s11657-023-01254-6

DO - 10.1007/s11657-023-01254-6

M3 - Article

C2 - 37119328

AN - SCOPUS:85156117669

SN - 1862-3514

VL - 18

JO - Archives of Osteoporosis

JF - Archives of Osteoporosis

IS - 1

M1 - 56

ER -

Hip fracture incidence and post-fracture mortality in Victoria, Australia: a state-wide cohort study

Abstract

Keywords

UN SDGs

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Correction to: Hip fracture incidence and post-fracture mortality in Victoria, Australia: a state-wide cohort study (Archives of Osteoporosis, (2023), 18, 1, (56), 10.1007/s11657-023-01254-6)

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