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Age Ageing. 2019 May 13. pii: afz048. doi: 10.1093/ageing/afz048. [Epub ahead of print]

Excess mortality following hip fracture in patients with diabetes according to age: a nationwide population-based cohort study of 154,047 hip fracture patients.

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Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Department of Orthopedic Surgery, Bispebjerg Hospital, Copenhagen, Denmark.
Department of Clinical Biochemistry, Hvidovre Hospital, Hvidovre, Denmark.
Odense Patient Data Explorative Network, University of Southern Denmark and Odense University Hospital, Odense, Denmark.
Department of Clinical Biochemistry, Bispebjerg Hospital, Copenhagen, Denmark.
Department of Medicine, Holbæk Hospital, Holbæk, Denmark.



to test the hypothesis that excess mortality conferred by diabetes following hip fracture decreases with advancing age.


a nationwide population-based cohort study including 154,047 patients who were admitted with a hip fracture in Denmark from 1996 to 2012. Information on hip fracture diagnosis, diabetes, other comorbidities, and the primary outcome all-cause mortality was collected using the national Danish health registries. The association between diabetes and all-cause mortality according to age was assessed using Cox proportional hazards regression in the age categories: <50, 50-59, 60-69, 70-79, 80-89 and ≥90 years.


during a median follow-up of 3 years (interquartile range: 1-6 years, 603,091 person-years) 114,990 died from any cause. In total, 8% (n = 12,158) of the patients had diabetes at baseline and had unadjusted, and age, sex and Charlson Comorbidity Index adjusted hazard ratios for all-cause mortality of 1.19 (95% confidence interval: 1.16-1.21) and 1.14 (1.12-1.17) as compared to patients without diabetes. The sex and Charlson Comorbidity Index adjusted hazard ratios according to age were 1.64 (1.34-2.02) for patients <50 years, 1.26 (1.12-1.40) for patients 50-59 years, 1.21 (1.13-1.29) for patients 60-69 years, 1.11 (1.07-1.16) for patients 70-79 years, 1.10 (1.07-1.14) for patients 80-89 years and 1.09 (1.02-1.16) for patients ≥90 years. There was a statistically significant interaction between diabetes and age (P < 0.001).


diabetes is associated with excess mortality following hip fracture across all ages, but the excess mortality decreases with advancing age.


ageing; endocrinology; epidemiology; fragility fracture; osteoporosis; survival


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