Falls and comorbidity: The pathway to fractures

Terese Sara Høj Jørgensen; Annette Højmann Hansen; Marie Sahlberg; Gunnar H Gislason; Christian Torp-Pedersen; Charlotte Andersson; Ellen Holm

doi:10.1177/1403494813516831

Falls and comorbidity: The pathway to fractures

Terese Sara Høj Jørgensen, Annette Højmann Hansen, Marie Sahlberg, Gunnar H Gislason, Christian Torp-Pedersen, Charlotte Andersson, Ellen Holm

26 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Scandinavian Journal of Public Health
Volume	42
Issue number	3
Pages (from-to)	287-294
Number of pages	8
DOIs	https://doi.org/10.1177/1403494813516831
Publication status	Published - May 2014

Keywords

Accidental Falls
Aged
Aged, 80 and over
Cause of Death
Comorbidity
Databases, Factual
Dementia
Denmark
Depression
Diabetes Mellitus
Female
Heart Failure
Hip Fractures
Humans
Male
Myocardial Ischemia
Osteoporosis
Parkinson Disease
Pulmonary Disease, Chronic Obstructive
Retrospective Studies
Risk Factors
Shoulder Fractures
Stroke
Time Factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/1403494813516831

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@article{ceb58ae309bb4474933e4916be7ba581,

title = "Falls and comorbidity: The pathway to fractures",

abstract = "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.",

keywords = "Accidental Falls, Aged, Aged, 80 and over, Cause of Death, Comorbidity, Databases, Factual, Dementia, Denmark, Depression, Diabetes Mellitus, Female, Heart Failure, Hip Fractures, Humans, Male, Myocardial Ischemia, Osteoporosis, Parkinson Disease, Pulmonary Disease, Chronic Obstructive, Retrospective Studies, Risk Factors, Shoulder Fractures, Stroke, Time Factors",

author = "J{\o}rgensen, {Terese Sara H{\o}j} and Hansen, {Annette H{\o}jmann} and Marie Sahlberg and Gislason, {Gunnar H} and Christian Torp-Pedersen and Charlotte Andersson and Ellen Holm",

year = "2014",

month = may,

doi = "10.1177/1403494813516831",

language = "English",

volume = "42",

pages = "287--294",

journal = "Acta socio-medica Scandinavica",

issn = "1403-4948",

publisher = "SAGE Publications",

number = "3",

}

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 - 1403-4948

VL - 42

SP - 287

EP - 294

JO - Acta socio-medica Scandinavica

JF - Acta socio-medica Scandinavica

IS - 3

ER -

Falls and comorbidity: The pathway to fractures

Abstract

Keywords

UN SDGs

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