Hip, back fractures raise risk of death: study

NEW YORK (Reuters Health) - Men and women who break their hip or backbone are at increased risk of dying prematurely, according to a study published this week.

According to the results, about 25 percent of men and women who fracture their hip and 16 percent who fracture their spine will die over a 5-year period.

"Hip fractures may have long-lasting effects that result in eventual death by signaling or actually inducing a progressive decline in health," Dr. George Ioannidis, from McMaster University, Hamilton, Ontario, and coauthors report in the Canadian Medical Association Journal (CMAJ).

The findings are based on 7753 randomly selected people from Canada aged 50 and older.

After adjustment for other risk factors, participants with a spine or "vertebral" fracture during the second year of follow-up had a 2.7-fold increased risk of death, and those with hip fracture during the first year of follow-up had a 3.2-fold increased risk of death, compared with participants with no new fractures.

Among women, the risk of death was increased 3.7-fold after vertebral fracture in the first year of follow-up, 3.2-fold after a vertebral fracture in the second year of follow-up, and 3.0-fold after a hip fracture in the first year of follow-up.

The relationship between fractures and premature death was inconclusive for men.

Except for rib fractures, all types of fracture were more common among women than among men, the researchers found. Other factors that increased the risk of death in fracture patients included smoking, lack of regular physical activity, and the presence of other diseases.

Interventions, the researchers say, are needed to reduce the likelihood of fractures, such as medications for the bone-thinning disease osteoporosis.

"Currently we have very effective treatments for osteoporosis that can nearly reduce the risk of fracture by 50%, and some work within 6 months," Ioannidis noted in a telephone interview with Reuters Health.

"So we can prevent fractures and the consequences of fractures (increased illness and death)," he added.

Other interventions such as fall prevention strategies, hip protectors and enhanced rehabilitation after fracture to improve mobility and strength are also needed, the researchers say.

SOURCE: Canadian Medical Association Journal (CMAJ), August 4, 2009.