TY - JOUR
T1 - Falls and comorbidity
T2 - The pathway to fractures
AU - Jørgensen, Terese Sara Høj
AU - Hansen, Annette Højmann
AU - Sahlberg, Marie
AU - Gislason, Gunnar H
AU - Torp-Pedersen, Christian
AU - Andersson, Charlotte
AU - Holm, Ellen
PY - 2014/5
Y1 - 2014/5
N2 - AIMS: To compare nationwide time trends and mortality in hip and proximal humeral fractures; to explore associations between incidences of falls risk related comorbidities (FRICs) and incidence of fractures.METHODS: The study is a retrospective cohort study using nationwide Danish administrative registries from 2000 through 2009. Individuals aged 65 years or older who experienced a hip or a proximal humeral fracture were included. Incidence of hip and of proximal humeral fractures, incidence of FRICs (ischemic heart disease, COPD, dementia, depression, diabetes, heart failure, osteoporosis, Parkinson's disease and stroke) and incidence rate ratios (IRR) for fractures in patients with FRICs, and all-cause mortality up to 10 years after a hip or a proximal humeral fracture were analysed.RESULTS: A total of 89,150 patients experienced hip fractures and 48,581 proximal humeral fractures. From 2000 through 2009, the incidence of hip fractures per 100,000 individuals declined by 198 (787 to 589, OR = 0.75, CI: 0.72-0.80) among males and by 483 (1758 to 1275, OR = 0.74, CI: 0.72-0.77) among females. Incidences of FRICs decreased. The absolute reduction in fractures was most pronounced for the age group above 75 years (2393 to 1884, OR = 0.81, CI: 0.78-0.83), but the relative reduction was more pronounced in the age group of 65-75 years old (496 to 342, OR = 0.70, CI: 0.66-0.74). IRRs for hip fractures and for proximal humeral fractures were significantly elevated in patients with FRICs.CONCLUSIONS: The results suggest that the overall reduction in fractures can be explained by reduction in falls related comorbidity.
AB - AIMS: To compare nationwide time trends and mortality in hip and proximal humeral fractures; to explore associations between incidences of falls risk related comorbidities (FRICs) and incidence of fractures.METHODS: The study is a retrospective cohort study using nationwide Danish administrative registries from 2000 through 2009. Individuals aged 65 years or older who experienced a hip or a proximal humeral fracture were included. Incidence of hip and of proximal humeral fractures, incidence of FRICs (ischemic heart disease, COPD, dementia, depression, diabetes, heart failure, osteoporosis, Parkinson's disease and stroke) and incidence rate ratios (IRR) for fractures in patients with FRICs, and all-cause mortality up to 10 years after a hip or a proximal humeral fracture were analysed.RESULTS: A total of 89,150 patients experienced hip fractures and 48,581 proximal humeral fractures. From 2000 through 2009, the incidence of hip fractures per 100,000 individuals declined by 198 (787 to 589, OR = 0.75, CI: 0.72-0.80) among males and by 483 (1758 to 1275, OR = 0.74, CI: 0.72-0.77) among females. Incidences of FRICs decreased. The absolute reduction in fractures was most pronounced for the age group above 75 years (2393 to 1884, OR = 0.81, CI: 0.78-0.83), but the relative reduction was more pronounced in the age group of 65-75 years old (496 to 342, OR = 0.70, CI: 0.66-0.74). IRRs for hip fractures and for proximal humeral fractures were significantly elevated in patients with FRICs.CONCLUSIONS: The results suggest that the overall reduction in fractures can be explained by reduction in falls related comorbidity.
KW - Accidental Falls
KW - Aged
KW - Aged, 80 and over
KW - Cause of Death
KW - Comorbidity
KW - Databases, Factual
KW - Dementia
KW - Denmark
KW - Depression
KW - Diabetes Mellitus
KW - Female
KW - Heart Failure
KW - Hip Fractures
KW - Humans
KW - Male
KW - Myocardial Ischemia
KW - Osteoporosis
KW - Parkinson Disease
KW - Pulmonary Disease, Chronic Obstructive
KW - Retrospective Studies
KW - Risk Factors
KW - Shoulder Fractures
KW - Stroke
KW - Time Factors
U2 - 10.1177/1403494813516831
DO - 10.1177/1403494813516831
M3 - Journal article
C2 - 24434943
SN - 1403-4956
SN - 1651-1905
VL - 42
SP - 287
EP - 294
JO - Scandinavian Journal of Public Health
JF - Scandinavian Journal of Public Health
IS - 3
ER -