Is there a difference in timing and cause of death after fractures in the elderly?

Background: Patients who sustain osteoporotic fractures have excessive mortality compared to age-matched controls, which is most pronounced within the first 6 months postfracture. However, the timing and cause of death in the first 3 months after sustaining a fracture are unclear.

Questions/purposes: We therefore evaluated and compared the timing and cause of death in patients who sustained a pelvic, proximal femoral, spinal, or proximal humeral fracture 30 and 90 days after fracture.

Methods: From medical records, we recorded age at time of fracture, sex, fracture site, comorbidities, date of death, and cause of death of 1630 patients with 1630 fractures admitted to our department between 2001 and 2007. The median age at the time of fracture was 83 years and 89% of the patients were women.

Results: Fifty-eight patients died within 30 days after fracture (3.6%), and 122 patients (7.5%) died within 90 days after fracture. Cardiovascular causes of death were most frequent in all fracture groups. Patients who suffered from spinal fractures died earlier within 30 days after fracture than patients who suffered from other types of fractures.

Conclusions: This shows the severity and impact of a spinal injury compared to other typical fragility fractures.