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More People Are Living With, Not Dying From, Hip Fractures

Cheryl Clark, for HealthLeaders Media, October 14, 2009

First, the good news. The percentage of the population suffering hip fractures has declined and fewer people are dying from them.

Now, the bad news. Patients who do fracture their hip and live to tell about it are more likely to have more co-morbidities, such as heart failure, pulmonary disease, and diabetes.

For example: the percentage of hip fracture patients living with congestive heart failure nearly doubled, from around 13% to more than 25%, between 1986-1988 and 2003-2005. And the percentage of patients with diabetes and hip fracture increased from 9.6% to 25% for men and more than 19% for women.

And patients with hip fracture are also more likely to have diabetes.

Those are findings from a study published in today's Journal of the American Medical Association by researchers at the University of Calgary, Alberta, Harvard University, and the University of Michigan School of Medicine and Public Health.

The authors wrote that there has been a distinct shift in hip fractures after 1995, when hip fractures decreased in both men and women.

"Why these trends have occurred is not entirely clear," the authors wrote, noting that it occurred after the release of bisphosphonate drugs, such as alendronate and risedronate.

Another possibility is in the emphasis on lifestyle change among older Americans, such as more people taking calcium and vitamin D supplements, "avoidance of smoking, regular weight bearing exercise, an awareness of falls, and moderate alcohol intake."

Also, they said, "publicity and physician education and awareness of osteoporosis and fragility fractures" have also increased since 1995, "which may be a contributing factor."

The authors noted that there also has been a reduction in mortality from hip fractures, but most of the decrease occurred before 1998. After 1998, they said, very little change occurred in mortality for either sex.

Surgical and medical management of hip fracture patients has improved over the last 20 years, "including care maps to improve timely surgical intervention, improved surgical devices, and movement toward replacement arthroplasty, combined with a push for earlier weight bearing exercises may have reduced mortality by improving mobilization," they wrote.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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