Data describing excess mortality after hip fracture is well established in developed countries in Western Europe and North America. However, estimates of hip fracture mortality in Eastern Europe are scarce. This study estimated the impact of hip fracture on 10-year, all-cause mortality among the Estonians 50 years of age or older.

This population-based, retrospective, cohort study used data from the Estonian Health Insurance Fund, which contains a complete record of inpatient and outpatient healthcare services. This record was reviewed for all patients hospitalized with incident hip fractures between January 1, 2005, and December 31, 2013. The patients were followed until the study′s closure in 2016 or the date of death. The hip fracture patients were compared with matched controls.

During follow-up, the cumulative risks of death at three months were 17.5% for the hip fracture group and 2.0% for the control group. At one, five and 10 years′ follow-up, the crude cumulative risks of death in the hip fracture group, as compared with the control group, were 28.3%, and 7.8%, 54.4% and 29.8% and 78.2% and 55.6%, respectively. The adjusted, cumulative, ten-year risks of all-cause death were 77.6% in the fracture group and 56.5% in the control group. At 10 years from fracture, one of four deaths in the hip fracture group was attributable to the patient′s hip fracture.

This Eastern Europe study found that, 10 years after hip fracture, adjusted all-cause mortality was 77.6%, as compared with 56.5% for the general population.