Researchers at the University of Adelaide say they're concerned about the findings of new research confirming that older men have a much higher risk of dying in the first 12 months after a hip fracture.
The University's Centre for Orthopaedic & Trauma Research investigated data of 728 South Australian patients with hip fractures over a 10-year period.
"There has been evidence that being male is an independent risk factor for early death after a hip fracture. But until we had the results of this study, we didn't realise the extent of the problem, which is particularly significant given recent improvements in hip fracture care and outcomes," says research leader Associate Professor Mellick Chehade, from the University's Centre for Orthopaedic & Trauma Research, and an Orthopaedic Trauma Consultant with the Royal Adelaide Hospital.
The study found:
• Most hip fractures occurred among women (71%)
• Most occurred in men and women living independently at home (58%) rather than in residential care
• Men living at home were twice as likely to die within the first 12 months after a hip fracture than women (29% compared with 14%)
• Men living in residential care were 1.3 times more likely to die within the first 12 months after a hip fracture than women (57% compared with 43%).
"These figures serve to highlight the major impact a hip fracture can have on elderly people's overall health and quality of life," Associate Professor Chehade says.
"The positive from this study is that the overall mortality of female patients at 12 months is among the lowest published anywhere the world.
"However, hidden in this predominantly female group was the fact that almost one in three men living at home die within the first 12 months of suffering a hip fracture. This is the part that is quite alarming. Now we know what the figures say, but at this stage it remains a mystery as to why this is happening to men."
Associate Professor Chehade says some male patients had a greater prevalence of complications after being hospitalised and had a longer stay in hospital. "We suspect that there may be other underlying, complex health issues in this group of men that have not come to light, which exacerbate their likelihood of early death. It is critical that we understand these issues if we are to appropriately address them," he says.
"While we can easily capture the reasons during the time of care within a hospital, once the patient returns to the community it is much more difficult to follow up – both to instruct care and record outcomes."
Associate Professor Chehade says further studies are needed to identify specific risk factors in men so that prevention strategies can be developed. "This includes better systems to link ongoing specialist management with community-based programs, while delivering patient-centred care," he says.
Associate Professor Mellick Chehade
Centre for Orthopaedic & Trauma Research
The University of Adelaide
and Orthopaedic Trauma Consultant
Royal Adelaide Hospital
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