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Invited Commentary | Nov 14, 2011

Goals of Care for Hip Fracture: Comment on “Hip Fracture and Increased Short-term but Not Long-term Mortality in Healthy Older Women”

C. Seth Landefeld, MD

Arch Intern Med. 2011;171(20):1837-1838. doi:10.1001/archinternmed.2011.534.

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Hip fractures are common and serious.¹^- 2 Nearly 20% of American women and 10% of American men will break a hip, almost always during a fall. Despite effective approaches to preventing falls and fractures, the incidence of hip fracture rises with age, and the number of people breaking a hip in the United States has risen to more than 300 000 annually.

Globally, hip fracture ranks among the top 10 causes of lost disability-adjusted life-years for people older than 50 years.²^- 3 Among people who lived independently before a hip fracture, only half walk independently again, and about 20% move to a long-term care facility and never return home. Hip fracture is also associated with increased risk of death. In a recent meta-analysis⁴ of 39 studies, older adults had a 5- to 8-fold increased risk of death during the 3 months after hip fracture; this fell to a 2-fold increase in risk of death after 6 months.

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Landefeld C. Goals of Care for Hip Fracture: Comment on “Hip Fracture and Increased Short-term but Not Long-term Mortality in Healthy Older Women”. Arch Intern Med. 2011;171(20):1837-1838. doi:10.1001/archinternmed.2011.534.

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