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Chronic obstructive pulmonary disease and mortality following hip fracture: a population-based cohort study

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Abstract

Introduction: Mortality rates after hip fracture have not declined in 20 years. We assessed the impact of chronic obstructive pulmonary disease (COPD) on mortality after hip fracture, and compared mortality in this cohort to persons without hip fracture in a population-based prospective cohort study. Methods: Using Danish health care registries, we identified persons ≥40 years old with first-time hospitalization for hip fracture between 1/1/1998 and 1/31/2003. Hospitalization for COPD was assessed from hospital discharge registries. Using Cox regression, we computed relative risks (RR) and 95% confidence intervals (CI) for mortality endpoints among persons with COPD compared to persons without COPD. Mortality following hip fracture was also compared to age and gender matched controls without hip fracture. Results: We identified 11, 985 persons with first-time hospitalization for hip fracture; 771 (6.4%) had a diagnosis of COPD. Average follow up was 22 months. Compared to persons without COPD, mortality following hip fracture in persons with COPD was RR = 1.58 (95% CI 1.30–1.90) at 30 days, RR = 1.52 (95% CI 1.30–1.77) at 90–days, RR = 1.58 (95% CI 1.40–1.78) at 1 year, and RR = 1.71 (95% CI 1.55–1.88) overall. The 1-year mortality in persons with hip fracture and COPD was approximately 3–5 times greater than in controls without hip fracture. Conclusions: In this cohort, persons with COPD have a 60–70% higher risk of death following hip fracture than those without COPD. In addition, hip fracture and COPD increased 1-year mortality 3–5 times that of persons without hip fracture.

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Abbreviations

AR:

Attributable risk

ATC:

Anatomical therapeutic chemical

CI:

Confidence interval

COPD:

Chronic obstructive pulmonary disease

ICD:

International classification of disease

No:

Number

RR:

Relative risk

SE:

Standard error

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Acknowledgements

This research represents a portion of Cynthia de Luise’s doctoral dissertation which was performed under a cooperative agreement between the Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark and UMDNJ School of Public Health, Newark, New Jersey. The health care databases at the Department of Clinical Epidemiology at Aarhus University Hospital are supported by the Western Danish Research Forum for Health Sciences.

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Authors and Affiliations

  1. Department of Epidemiology, University of Medicine and Dentistry of New Jersey (UMDNJ) School of Public Health, Newark, NJ, USA

    Cynthia de Luise

  2. Epidemiology, Pfizer Inc, New York, NY, USA

    Cynthia de Luise

  3. New Jersey Medical School and School of Public Health, Department of Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey (UMDNJ), Newark, NJ, USA

    Michael Brimacombe

  4. Department of Clinical Epidemiology, Aarhus University Hospital, 8000, Aarhus, Denmark

    Lars Pedersen & Henrik Toft Sørensen

  5. Department of Epidemiology, Boston University, Boston, MA, 02215, USA

    Henrik Toft Sørensen

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  1. Cynthia de Luise
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  4. Henrik Toft Sørensen
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Correspondence to Cynthia de Luise.

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de Luise, C., Brimacombe, M., Pedersen, L. et al. Chronic obstructive pulmonary disease and mortality following hip fracture: a population-based cohort study. Eur J Epidemiol 23, 115–122 (2008). https://doi.org/10.1007/s10654-007-9211-5

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  • DOI: https://doi.org/10.1007/s10654-007-9211-5

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