DOS 2017

DOS Kongressen 2017 ·

Hip fracture, comorbidity, and the risk of myocardi-

al infarction and stroke: A Danish nationwide cohort

study, 1995-2015

Alma B Pedersen , Vera Ehrenstein, Szimonetta K. Szépligeti, Henrik T Sørensen

Department of Clinical Epidemiology, Aarhus Universityhospital;

Background:

Hip fracture is a common trauma, associated with high morbidity

and mortality.

Purpose / Aim of Study:

We evaluated risks of MI and stroke in hip fracture

patients compared with general population. We also examined the interaction

between hip fracture and comorbidity with respect to risks of MI or stroke,

defined as excess of risk explained by combining risks of hip fracture and co-

morbidity.

Materials and Methods:

A population-based cohort study using Danish

health registries from 1995-2015 including 110,563 hip fracture patients

and 552,774 members of the 2015 including 110,563 hip fracture patients

and 552,774 members of the comparison cohort from the general population.

comparison cohort from the general population.

Findings / Results:

Thirty-day cumulative incidences of MI were 1.15% among

patients with hip fracture and 0.09% in the general population (adjusted hazard

ratio (aHR) = 12.97 (95% confidence interval (CI): 11.56-14.55)). Thirty-day

cumulative incidences of stroke were 2.16% for hip fracture patients and 0.21%

in the general population (aHR= 9.42 (95% CI: 8.71-10.19)). During the 31-

365 days following hip fracture, the aHR for MI was 1.05 (95% CI: 0.97-1.14)

and remained at this level during the remainder of follow-up (maximum of 20

years). The aHR for stroke was 1.29 (95% CI: 1.22-1.35) during the 31-365

days following hip fracture, remained elevated for up to 10 years, and then

decreased to the general-population level. During the first 30 days, up to 76%

of MI and stroke risk was attributable to interaction between hip fracture and

comorbidity.

Conclusions:

Patients with hip fracture are at increased risk of both MI and

stroke up to one year following the fracture. Risk of stroke, but not of MI, was

elevated during up to 10 years post-fracture. Although the absolute risks were

low, our finding underscores the importance of targeting multimorbidity, includ-

ing prevention and adequate treatment, to improve the prognosis of hip frac-

ture patients.

No conflicts of interest reported

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