Hip Fracture Dangers and Mortality Rates

A hip fracture, more common in older people, can reduce a person's ability to live independently and possibly shorten their life as well. If you are older and have a hip fracture, reduced mobility can lead to bed sores, blood clots in the legs or lungs, and the loss of muscle mass (which increases the risk of falls and re-injury).

A hip fracture is also associated with a higher mortality (death) rate in older adults compared to those who do not suffer a break. Pneumonia is among the most common causes of early death in this group.

This article explains how a hip fracture increases the risk of mortality and the various factors that place an older adult at risk of death following a broken hip.

Incidence of Hip Fractures

Falls are the leading cause of injury and injury-related deaths in adults over 65.  It is estimated that around 300,000 hip fractures occur in the United States each year, mainly due to falls in older adults who are inherently vulnerable to broken hips.

The impact is not only felt on an individual basis but on a population-based level. Hip fractures place a substantial economic strain on the U.S. healthcare system, accounting for roughly $5.96 billion per year in direct medical costs, based on a 2019 review of Medicare claims.

Mortality Rates

The mortality rate is the measurement of the proportion of deaths that occurs within a specific time frame and within a specific population. The rates are described in percentages.

According to a 2019 study in Acta Orthopaedica, the one-year mortality after a hip fracture is 21% for those whose fracture is surgically repaired. If the fracture is not repaired, the one-year mortality is about 70%. This means that, with optimal treatment, roughly four out of five people will survive for at least the first year following a hip fracture.

Even if a hip fracture is successfully treated, the disability caused by the break can continue to compound the mortality rate year after year.

A 2017 study in the Journal of Internal Medical involving 122,000 adults in the United States and Europe found that the all-cause mortality rate for people with a hip fracture doubled over the course of 12 years compared to a matched set of adults without a hip fracture. This means that the very fact that you've had a break reduces your life expectancy if you are over 65.

Fortunately, improved surgeries and rehabilitation strategies are starting to reverse mortality rates. While statistics have traditionally shown that one-third of older adults die within a year of a break, that figure has since been reduced to 21% in the United States, 23% in Europe, 25% in Australia, 27% in South America, and 18% in Asia.

Globally, the mortality rate for adults with hip fractures is roughly 22%.

Causes of Death After Hip Fracture

Several factors can increase the risk of death after a hip fracture. According to a 2015 study in the Bone and Joint Journal, the three most common causes of early death in people following a hip fracture were:

• Respiratory infections (35%), most commonly pneumonia
• Complications of coronary artery disease (21%), including a heart attack or stroke
• Complications of heart failure (13%), including acute kidney failure and multi-organ failure

Other causes include post-surgical complications such as pulmonary embolism (a blood clot in the lung), gastrointestinal bleeding, and sepsis (an immune overreaction to infection).

Most of these early deaths occur within one to three months of the break. Even if an older person survives beyond the critical one-year threshold, a hip fracture can continue to amplify the risk of death thereafter.

When a person's functional mobility is severely reduced, they are less able to manage chronic conditions like heart disease, diabetes, chronic kidney disease, and chronic obstructive pulmonary disease (COPD)—all of which are influenced by exercise and lean muscle mass. As result, they are more likely to succumb earlier to these diseases than peers who retain their functional mobility.