Racial and ethnic differences in hip fracture outcomes in men

Abstract

Objectives: To examine temporal trends and racial/ethnic differences in hip fracture incidence and mortality outcome in older men.

Study design: Retrospective cohort study.

Methods: We ascertained men 50 years or older with a hip fracture during 2000 to 2010 in a diverse northern California healthcare population. Age, comorbidity index, hip fracture incidence, and all-cause mortality up to 12 months post fracture were examined and compared by race/ethnicity.

Results: A total of 6247 men (aged 79.3 ± 9.8 years) experienced a hip fracture during 2000 to 2010: 81.4% were white, 7.5% Hispanic, 3.8% black, and 3.9% Asian. The age-adjusted annual incidence of hip fracture averaged 127 per 100,000, ranging from 116 to 139 per 100,000 during this period. In 2010, the age-adjusted incidence of hip fracture was highest among white men (137), followed by Hispanic (98) and black (80), and was lowest among Asian men (45 per 100,000). Mortality following hip fracture was 11.1%, 19.8%, 25.4%, and 32.9%, within 1, 3, 6, and 12 months, respectively, and increased with age. One-year mortality was similar for whites (33.7%), blacks (32.4%), and Hispanics (31.1%), but lower for Asians (23.1%; P <.05). Adjusting for age, comorbidity index, and calendar year, Asians remained at lower mortality risk compared with whites (adjusted odds ratio, 0.62; 95% confidence interval, 0.45-0.86).

Conclusions: Although hip fracture rates were largely stable among older men, contemporary rates of hip fracture were highest for white and lowest for Asian men. One-year mortality was similar for white, black, and Hispanic men, but significantly lower for Asians. Future studies should investigate factors underlying observed ethnic differences in fracture outcome among US men.