All-cause and cause-specific mortality after hip fracture among Chinese women and men
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ORIGINAL ARTICLE
All-cause and cause-specific mortality after hip fracture among Chinese women and men The Singapore Chinese Health Study G. C.-H. Koh & B. C. Tai & L.-W. Ang & D. Heng & J.-M. Yuan & W.-P. Koh
Received: 24 June 2012 / Accepted: 28 September 2012 / Published online: 9 December 2012 # International Osteoporosis Foundation and National Osteoporosis Foundation 2012
Abstract Summary All-cause mortality risk persisted for 5 years after hip fractures in both men and women. There may be genderspecific differences in effect and duration of excess risk for cause-specific mortality after hip fracture. Introduction To determine all-cause and cause-specific mortality risk in the first 5 years after hip fracture in an Asian Chinese population. Methods The Singapore Chinese Health Study is a population-based cohort of 63,257 middle-aged and elderly Chinese men and women in Singapore recruited between 1993 and 1998. This cohort was followed up for hip fracture and death via linkage with nationwide hospital discharge database and death registry. As of 31 December 2008, we identified 1,166 hip fracture cases and matched five nonfracture cohort subjects by age and gender for each fracture case. Cox proportional hazards and competing risks regression models with hip fracture as a time-dependent covariate
G. C.-H. Koh (*) : B. C. Tai : W.-P. Koh Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Block MD3, #03-20, 16 Medical Drive, 117597, Singapore, Singapore e-mail: [email protected] G. C.-H. Koh : B. C. Tai Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
L.-W. Ang Epidemiology and Disease Control Division, Ministry of Health, Singapore, Singapore
were used to determine all-cause and cause-specific mortality risk, respectively. Results Increase in all-cause mortality risk persisted till 5 years after hip fracture (adjusted hazard ratio, aHR 0 1.58 [95 % CI, 1.35–1.86] for females and aHR 0 1.64 [95 % CI, 1.30–2.06] for males). Men had higher mortality risk after hip fracture than women for deaths from stroke and cancer up to 1 year post-fracture but women with hip fracture had higher coronary artery mortality risk than men for 5 years post-fracture. Men had higher risk of death from pneumonia while women had increased risk of death from urinary tract infections. There was no difference in mortality risk by types of hip fracture surgery. Conclusions All-cause mortality risk persisted for 5 years after hip fractures in men and women. There are genderspecific differences in effect size and duration of excess mortality risk from hip fractures between specific causes of death.
D. Heng Public Health Group, Ministry of Health, Singapore, Singapore J.-M. Yuan Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA J.-M. Yuan Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, U
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