Survival rates after hip fracture worse than for many cancers

Bones are the foundation of our body, the foundation on which everything else depends for support and structure. But with age, bones become more porous, increasing the risk of fractures and fractures. While these may seem like minor injuries, they are anything but. An eye-opener new study shows that hip and spine fractures in older adults have a lower survival rate than many types of cancer.

These old bones

To study the impact of fractures on the life expectancy of older adults, a group of Canadian researchers searched the databases of the public health care system in Ontario, Canada. They collected data from nearly 100,000 individuals, all of whom were over 65 years old and had suffered a documented fracture in the hip or spine. Each participant was then matched with a control group of the same age, none of whom had recently suffered a fracture.

The findings were stark: Less than a third of men and half of women in the fracture group survived more than five years after the fracture. The outcome for vertebral fractures was only slightly better. And the older the participants, the lower the survival rate; those aged 85 and over had the worst outcomes. For reference, the five-year survival rate for patients aged 60 to 79 diagnosed with cancer is 64%. Even in patients 80 years and older, the survival rate for any cancer diagnosis is still around 43%, noticeably higher than for hip fractures.

Although women had better overall survival rates, they were more likely to suffer a fracture at all. This is because men generally have that denser bones, giving them a little more protection against damage. In addition, women who have gone through menopause no longer produce estrogen, an essential hormone for bone health.

The scientists also found that the first month after a fracture is the most critical period, with the most dramatic reduction in survival occurring at that time. This was true across the board, regardless of the age or gender of the participants.

Implications

This research yields a number of important findings. First, it highlights the danger that bone fractures—particularly hip and spine fractures—pose to older adults. Because the five-year survival rate is worse than for many types of cancer, the risk of fractures should not be overlooked. The scientists then managed to identify the first month after a rupture as a decisive period. Effective clinical intervention during that time could significantly reduce deaths from fractures. Clinicians need to be aware of the vicious ‘frailty-fracture’ cycle that some patients can become trapped in. Essentially, a fracture and subsequent bed rest make a patient more vulnerable, making him or her more susceptible to future fractures.

The findings also remind us of the age-old saying that prevention is better than cure. Maintaining strong, dense bones should be a top priority for older adults. This means exercise especially often weight training, which helps improve bone health. It also means eating one high protein diet to keep bones and muscles strong. Strong muscles ensure good balance, and good balance reduces the risk of accidental falls.