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A Quirky Picture For Risk Of Death After Hip Fracture

Among women 65 and older who break a hip, the risk of death doubles for up to a year afterward. But in a surprise, researchers found that for woman 70 and up the risk drops back to pre-fracture levels after a year. For the youngest elderly women, though, the risk remained high after a year.

One takeaway point of the research is that older women should try to reduce the chances of getting a hip fracture, the lead author of the study said. hide caption

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One takeaway point of the research is that older women should try to reduce the chances of getting a hip fracture, the lead author of the study said.

Lead author of the study Erin LeBlanc, an epidemiologist and endocrinologist at the Center for Health Research at Kaiser Permanente Northwest in Portland, Ore., says she was surprised that the youngest women in the study had the highest risk of dying soon after a fracture.

"I thought that women who were the youngest and the healthiest would be able to bounce back the quickest," LeBlanc told Shots.

But her team found just the opposite: Women between ages 65 to 69 who have a hip fracture were more than four times more likely to die within a year than women who haven't fractured a hip (16.3 percent died versus 3.7 percent, respectively). Also, women in that same age group continued to face an increased risk up to 10 years later.

At the same time, researchers found that among women ages 70 to 79, the risk of dying within a year doubled after a hip fracture. Women over 80 have the same risk of dying in a year whether or not they fracture a hip. But, among women older than 80 who are healthy, the risk almost triples.

For the paper, researchers looked at 10,000 participants tracked for more than two decades as part of the Study of Osteoporotic Fractures. Researchers selected 1,116 women who had hip fractures, and they compared these women to four women of the same age who didn't have a hip fracture. The paper appears in the Archives of Internal Medicine.

LeBlanc says that previous research establishes a link between hip fracture and risk of death.

"The point of our research," she says, "was to determine whether it was the hip fracture itself or if it was because of other medical conditions." LeBlanc says that the study's findings indicate that it's the fracture that increases the risk of death.

She points to one of the study's findings: that the younger women who had hip fractures in the study had the highest risk of death even though their age indicates they otherwise have a lower risk of mortality. Meanwhile, only healthy women over age 80 seemed to have high mortality rates after a hip fracture. This, despite the fact that their age puts them at a higher risk of mortality.

According to the Centers for Disease Control and Prevention, there were 281,000 hospital admissions for hip fractures among seniors in 2007. And the American Academy of Orthopaedic Surgeons reports that the average cost of hip fracture care is almost $27,000 per patient.

Why are older women who break a hip more likely to die? LeBlanc says it's likely because the stress of having a hip fracture and having the surgery could cause another problem to flare up — or it may exacerbate an existing condition.

LeBlanc notes, the women in the study "are dying of the same things that women who don't have hip fractures of dying of."

LeBlanc says there are two take-home points to her research. The first is to try to avoid breaking your hip altogether. LeBlanc says women go to the doctor, consider getting a bone density check, and consume an adequate amount of calcium and vitamin D. She also recommends that older women and their families minimize the risk of tripping in the home by doing things like checking the edges of the carpeting.

When women do get a hip fracture, this study, LeBlanc says, is a reminder that it's a critical time — and shows how important it is to take care of these women who are in a vulnerable state.