Fracture Location Can Have a Significant Impact on Long-Term Health

Older patients with fractures of proximal bones – humerus, femur, pelvis, and ribs – face a greater risk of being admitted to the hospital for major medical conditions and of dying prematurely following the fracture than similarly aged individuals without fractures, according to research accepted for presentation at ENDO 2020, the Endocrine Society’s annual meeting.

The Endocrine Society canceled ENDO 2020 amid concerns about COVID-19, but has announced that accepted abstracts will be published in a special supplemental section of the Journal of the Endocrine Society.

“It is well-known that a hip fracture can have devastating health implications for older individuals, but less is known about the effects of other fractures in the body,” said lead study author Jacqueline R. Center, PhD, of the Garvan Institute of Medical Research in Sydney, Australia.

“Not only should people be treated for their bone health, but we now have information allowing us to understand why people do badly after a fracture and how we may intervene to improve outcomes.”

The researchers used the Danish National Database to study outcomes of 300,000 patients age 50 or older who had sustained low-energy fractures. They examined differences in the reasons for subsequent hospital admission, as well as mortality patterns, between patients with proximal bone fractures and those with fractures of distal bones – wrist, ankle, hand, and foot. They matched patient with fractures to patients without fractures who had a similar age and other medical diagnoses.

Dr. Center and her colleagues found that patients with a fracture at a proximal site had a 1.5- to 4-fold greater risk of death over the subsequent 2 years than their non-fracture counterparts, whether they were admitted to the hospital after their fracture or not. The proximal fracture patients were also more likely to have an admission to the hospital for cardiovascular disease, cancer, stroke, diabetes, pneumonia, or lung disease. By contrast, patients with a distal fracture had a similar or lower risk of death and similar hospital admission patterns as their counterparts with no fractures.

“This research provides important insights as to why people who have a proximal fracture die prematurely,” Dr. Center said. She said further studies are needed to find specific ways of preventing these premature deaths.

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