Tohoku J. Exp. Med., 2012, 226(2)

A Comparison of Survival Rates for Hip Fracture Patients with or without Subsequent Osteoporotic Vertebral Compression Fractures

CHAYANIN ANGTHONG,¹ WIRANA ANGTHONG,² THOS HARNROONGROJ³ and THOSSART HARNROONGROJ³

¹Department of Orthopaedic Surgery, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
²Department of Radiology, Faculty of Medicine HRH Maha Chakri Princess Sirindhorn Medical Center, Srinakharinwirot University, Nakhon Nayok, Thailand
³Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Little is known about the effect of a subsequent osteoporotic vertebral compression fracture on the survival rate of patients with a previous hip fracture. In this study, we aimed to compare the survival rates of hip fracture patients with and without subsequent osteoporotic vertebral compression fractures and determine the risk factors associated with subsequent fracture. During 2000-2008, 933 initial hip fracture patients were reviewed and divided into two groups: subsequent fracture group (160 patients) and single hip fracture group (i.e., no subsequent fracture; 773 patients). All information pertaining to their most recent fracture event(s), including mortality causes/rates, were recorded. Differences in mortality rates and hazard ratios (HRs) between the two groups were also analyzed. The 1-year and 1-to-5-year mortality rates were 1.3% and 1.9%, respectively, in the subsequent fracture group, and 4.7% and 1.4%, respectively, in the single hip fracture group, with no significant differences observed. Interestingly, the HR for mortality was significantly higher in the single hip fracture group than in the subsequent fracture group (p < 0.05). The significant risk factors for subsequent fractures were identified as knee osteoarthritis, neurological disease, and an initial hip fracture with intertrochanteric involvement. Our findings indicate that the occurrence of a vertebral compression fracture after an initial hip fracture does not greatly impact patient survival. Conversely, patients presenting with a single hip fracture have a significantly higher mortality-HR, indicating that single hip fracture patients without subsequent fracture should be provided with the same standard of care as patients with subsequent fractures.

keywords —— hip fracture; mortality rate; risk factor; subsequent osteoporotic vertebral compression fracture; survival

© 2012 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2012, 226, 129-135

Correspondence: Thossart Harnroongroj, M.D., Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand.

e-mail: sitha@mahidol.ac.th, tmthr@mahidol.ac.th, chayaninboom@gmail.com