Increased mortality after lower extremity fractures in patients <65 years of age

Figures & data

Figure 1. Cumulative mortality of 2,081 women and 1,486 men (A) and of patients younger than (n = 1,639) and older than (n = 1,928) 65 years of age (B) who were treated for a lower extremity fracture.

Table 1. Distribution and SMRs of women and men treated for any lower extremity fracture

Fracture	< 65 years at time of fracture				≥ 65 years at time of fracture
site	n (men/women)	Person-years	Death	SMR (95% CI)	n (women/men)	Person-years	Death	SMR (95% CI)	p-value^a
Hip	160 (99/61)	875	44	6.7 (5.0–9.0)	1,435 (404/1,031)	4,941	999	2.2 (2.0–2.1)	< 0.001
Femur^b	51 (36/15)	313	9	7.1 (3.7–14)	84 (16/68)	291	59	2.1 (1.7–2.8)	< 0.001
Knee	191 (110/81)	1,221	19	3.3 (2.1–5.2)	138 (32/106)	670	64	1.6 (1.3–2.06)	0.006
Leg	361 (238/123)	2,387	22	2.1 (1.4–3.2)	57 (24/33)	335	10	0.56 (0.30–1.1)	< 0.001
Ankle	876 (465/411)	5,641	67	2.6 (2.0–3.3)	214 (62/152)	1,239	60	1.2 (0.94–1.6)	< 0.001

a p-value between age groups.

b Diaphysis.

SMR: standardized mortality ratio.

Figure 2. Standardized mortality ratios (SMRs) for different types of lower extremity fractures.

Table 2. The primary causes of death of 877 women and 476 men with lower extremity fractures

	Women (n = 877)			Men (n = 476)
Age, years	< 65	≥ 65	Total (%)	< 65	≥ 65	Total (%)
Certain infectious and parasitic diseases	0	5	5 (0.6)	1	3	4 (0.8)
Neoplasms	9	80	89 (10)	14	44	58 (12)
Endocrine, nutritional, and metabolic diseases	1	5	6 (0.7)	5	0	5 (1.1)
Mental and behavioral disorders	3	71	74 (8.4)	3	18	21 (4.4)
Diseases of the nervous system	5	108	113 (13)	3	39	42 (8.8)
Diseases of the circulatory system	7	383	390 (45)	26	146	172 (36)
Diseases of the respiratory system	3	36	39 (4.4)	2	36	38 (8.0)
Diseases of the digestive system	4	25	29 (3.3)	15	8	23 (4.8)
Diseases of the skin and subcutaneous tissue	0	1	1 (0.1)	1	0	1 (0.2)
Diseases of the musculoskeletal system and connective tissue	0	3	3 (0.3)	0	6	5 (1.1)
Diseases of the genito-urinary system	0	14	14 (1.6)	1	3	4 (0.8)
Congenital malformations, deformations, and chromosomal abnormalities	1	1	2 (0.2)	0	0	0 (0)
Symptoms, signs, and abnormal clinical and laboratory findings not classified elsewhere	0	1	1 (0.1)	3	1	4 (0.8)
External causes of morbidity and mortality	11	91	102 (12)	38	57	95 (20)
Unknown	1	8	9 (1.0)	4	0	4 (0.8)