Incidence, Morbidity and Mortality in Patients Older than 50 Years with Second Hip Fracture in a Jeju Cohort Study

PURPOSE Although the incidence of a second hip fracture is relatively well described, mortality and morbidity after a second hip fracture are seldom evaluated. The purpose of this study was to determine the incidence, morbidity, and mid-term mortality of a second hip fracture and evaluate the cause of death after a second hip fracture. MATERIALS AND METHODS Information on patients older than 50 years, who sustained a subsequent hip fracture, were obtained from the records of eight Jeju Island hospitals between 2002 and 2011 to calculate the incidence, morbidity, and mortality of hip fractures in this age group. All patients were followed a minimum of 2 years. A systemic search for death certificates at the National Statistical Office was conducted for patients who were lost to follow-up. RESULTS Of 2,055 hip fractures (419 men and 1,636 women), 98 were second hip fractures (13 men and 85 women) during the study period. The mean ages of the patients at the time of the first and second fractures were 78.8 and 80.8 years, respectively. The incidence of a subsequent hip fracture among the first hip fracture was 4.8%. Mean mortality rates at 6 months, 1 year, 2 years, and 5 years were 10.5%, 15.2%, 23.5%, and 42.0% respectively. Cumulative mortality after the second hip fracture at the 5 years follow-up was 41.8%. CONCLUSION Our results demonstrate that a secondary fracture prevention program is necessary to prevent second hip fractures in elderly patients.