Short summary

Hip fractures are one of the most serious complications of osteoporosis leading to increased mortality, morbidity and cost to society. Many studies have investigated risk factors associated with increased mortality but few are concerned with the results of blood samples taken at admission and discharge. There is also very limited knowledge on the causes of death and development of co-morbidities in these patients.

Rationale

The incidence of hip fractures has been found to decrease to an extent too large to be explained by anti-osteoporotic treatment etc. Other explanations could be changes in smoking habits, obesity, improved general health or other patient related characteristics including co-morbidity. Studies on these factors have shown increased risk associated with some of them, but knowledge on the development over time is sparse.

The project is a register-based, epidemiological study consisting of six sub-studies with the purpose of investigating the effect of biochemical markers, co-morbidity, socioeconomic factors and medical/surgical treatments on mortality and other adverse outcomes in hip fracture patients.

Description of the cohort

The data for the project has already been collected and uploaded to Statistics Denmark. Data consists of 8.400 patients admitted to Bispebjerg Hospital with a hip fracture during the period January 1996 to November 2013.

Data and biological material

The database contains information on: Social security number, date of admission, date of discharge, department of admission, diagnosis, date of operation, fracture type, type of operation, etc. At Statistics Denmark these data are linked to data on all hospital admissions, diagnoses, medication use, emigration, death etc.

Furthermore, a dataset containing all patients who have sustained a hip fracture during the period January 1995 to December 2013 (N=156.000), together with an age and sex matched control group who have not sustained a hip fracture with the ratio of 1:3, has been created at Statistics Denmark.

Subprojects

The following projects are planned and should result in several publications.

1. Development over time in the incidence of hip fractures and patterns of mortality; The influence of co-morbidity, medications, and other co-variates.
2. The development in causes of death in hip fracture patients.
3. The predictive value of blood samples at admission on mortality in hip fracture patients.
4. The predictive value of blood samples at discharge on mortality in hip fracture patients.
5. The effect of socioeconomic factors on hip fracture mortality.
6. Mortality, morbidity, readmission and re-fracture rates as function of anti-osteoporotic treatment and blood samples.

Collaborating researchers and departments

Department of Orthopedic Surgery, Bispebjerg Hospital

• Christopher Jantzen, MD
• Christian Medom Madsen, MD
• Professor Jes B. Lauritzen, MD, DMSc

Department of Clinical Biochemistry, Bispebjerg Hospital

• Henrik L. Jørgensen, MD, PhD

Institute of Clinical Research, University of Southern Denmark

• Professor Bo Abrahamsen, MD, PhD

Social and Behavioral Sciences Department, Boston University School of Public Health

• Professor Jonathan Howland, PhD, MPH

Publications associated with the project

Low Levels of Hemoglobin at Admission Are Associated With Increased 30-Day Mortality in Patients With Hip Fracture. / Praetorius K, Madsen CM, Abrahamsen B, Jørgensen HL, Lauritzen JB, Laulund AS; Geriatr Orthop Surg Rehabil. 2016 Sep;7(3):115-20. 

Hyponatremia and hypernatremia are associated with increased 30-day mortality in hip fracture patients. / Madsen CM, Jantzen C, Lauritzen JB, Abrahamsen B, Jorgensen HL. Osteoporos Int. 2016 Jan;27(1):397-404.