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Mortality Following Hip Fracture in Older Adults With and Without Coronary Heart Disease.

TitleMortality Following Hip Fracture in Older Adults With and Without Coronary Heart Disease.
Publication TypeJournal Article
Year of Publication2023
AuthorsRobbins, JA, Bůzková, P, Barzilay, JI, Cauley, JA, Fink, HA, Carbone, LD, Chen, Z, Stein, PK, Elam, R, Sheets, K, Mukamal, KJ
JournalAm J Med
Date Published2023 Apr 24
ISSN1555-7162
Abstract<p><b>BACKGROUND: </b>Comorbidities like coronary heart disease are common among older people who sustain an osteoporotic hip fracture. However, their impact on short- and long-term mortality post-hip fracture is not well quantified.</p><p><b>METHODS: </b>We examined 4092 and 1173 older adults without and with prevalent coronary heart disease, respectively. Post-hip fracture mortality rates were computed with Poisson models and hazard ratios with Cox regression. For perspective, we compared mortality rates among participants with prevalent coronary heart disease who had either a hip fracture or incident heart failure (but no hip fracture).</p><p><b>RESULTS: </b>Among participants without prevalent coronary heart disease, the mortality rate post-hip fracture was 21.83 per 100 participant years, including 49.27 per 100 participant years in the first 6 months following hip fracture. Among participants with prevalent coronary heart disease, the corresponding mortality rates were 32.52 and 79.44 per 100 participant years, respectively. Participants with prevalent coronary heart disease and incident heart failure (but no hip fracture) had corresponding post-incident heart failure mortality rates per 100 participant years of 25.62 overall and 46.4 in the first 6 months. In all 3 groups, the hazard ratio for mortality was similarly elevated: 5- to 7-fold at 6 months and 1.7- to 2.5-fold beyond 5 years.</p><p><b>CONCLUSION: </b>As a case study in the absolute effects of a comorbidity on post-hip fracture mortality, hip fracture in a person with coronary heart disease carries an exceedingly high mortality rate, even higher than that following incident heart failure in individuals with coronary heart disease.</p>
DOI10.1016/j.amjmed.2023.03.036
Alternate JournalAm J Med
PubMed ID37100188
ePub date: 
23/04