Open Access Highly Accessed Research article

Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study

Jorma Panula1*, Harri Pihlajamäki2, Ville M Mattila3, Pekka Jaatinen4, Tero Vahlberg5, Pertti Aarnio67 and Sirkka-Liisa Kivelä1089

Author Affiliations

1 Department of Surgery, City Hospital of Pori, Pori, Finland

2 Centre for Military Medicine, Helsinki, Finland

3 Division of Orthopaedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Tampere, Finland

4 Rauma Health Office, Rauma, Finland

5 Department of Biostatistics, University of Turku, Turku, Finland

6 Department of Surgery, Satakunta Central Hospital, Pori, Finland

7 Department of Surgery, University of Turku, Turku, Finland

8 Department of Family Medicine, University of Turku, Turku, Finland

9 Department of Family Medicine, Turku University Central Hospital, Turku, Finland

10 Department of Family Medicine, Satakunta Central Hospital, Pori, Finland

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BMC Musculoskeletal Disorders 2011, 12:105  doi:10.1186/1471-2474-12-105

Published: 20 May 2011



The high mortality of hip fracture patients is well documented, but sex- and cause-specific mortality after hip fracture has not been extensively studied. The purpose of the present study was to evaluate mortality and cause of death in patients after hip fracture surgery and to compare their mortality and cause of death to those in the general population.


Records of 428 consecutive hip fracture patients were collected on a population-basis and data on the general population comprising all Finns 65 years of age or older were collected on a cohort-basis. Cause of death was classified as follows: malignant neoplasms, dementia, circulatory disease, respiratory disease, digestive system disease, and other.


Mean follow-up was 3.7 years (range 0-9 years). Overall 1-year postoperative mortality was 27.3% and mortality after hip fracture at the end of the follow-up was 79.0%. During the follow-up, age-adjusted mortality after hip fracture surgery was higher in men than in women with hazard ratio (HR) 1.55 and 95% confidence interval (95% CI) 1.21-2.00. Among hip surgery patients, the most common causes of death were circulatory diseases, followed by dementia and Alzheimer's disease. After hip fracture, men were more likely than women to die from respiratory disease, malignant neoplasm, and circulatory disease. During the follow-up, all-cause age- and sex-standardized mortality after hip fracture was 3-fold higher than that of the general population and included every cause-of-death category.


During the study period, the risk of mortality in hip fracture patients was 3-fold higher than that in the general population and included every major cause of death.