Hip fractures going down but comorbidities going up

Hip fracture rates and subsequent mortality among persons 65 years and older are declining. However, comorbidities among persons with hip fractures have increased.

Brauer and associates examined 20-year hip fracture/outcomes data and medication use from the US Medicare population. The study data encompassed 786,717 hip fractures in persons older than 65 years.

Hip fractures were almost twice as common in women as in men during the study period. The age-adjusted incidence of hip fracture increased between 1986 and 1995 (9% for women, 16.4% for men) but then decreased from 1995 to 2005 (24.5% for women, 19.2% for men).

The median length of hospital stay shortened from 12 days in the 1980s to 5 days in 2005. Postfracture survival improved, although reports of comorbidities increased (eg, congestive heart failure, chronic pulmonary disease, and diabetes mellitus). Medication use patterns also changed; fewer patients opted for hormone replacement and more chose bisphosphonates or selective estrogen receptor modulators. Adjusted 30-day mortality decreased by 11.9% in women and by a comparable percentage in men. The authors noted that an examination of the downstream clinical and economic outcomes of these trends is needed to determine their effects on patient and societal welfare.