Mortality after hip fracture: regional variations in New Zealand

Aim. To determine the 35-day and one-year mortality rates following a hospi tal admission for hip fracture, among individuals aged 60 years or older in New Zealand. Methods. New Zealand Health Information Service mortality data for the year s 1988 to 1992 were examined to determine the case fatality rate among indi viduals aged 60 years or older admitted to hospital for fractures of the ne ck of femur (ICD-9 N-code 820). Case fatality rates assessed at 35 days and one year after admission to hospital were examined by age, gender, year of admission, place of residence, area health board region and cause of death . Results. Between 1988 and 1992, the case fatality rate was 8% within 35 day s of admission to hospital and 24% within one year of admission. Case fatal ity rates were found to be twice as high in men compared to women and four to five times higher in individuals aged 85 years and older, compared to pe ople aged between 60 and 64 years. The only regional difference in hip frac ture mortality was found in the Canterbury area health board region, which had a 30% higher rate of hip fracture mortality compared to all regions com bined. The two main cited underlying causes of death after hip fracture wer e accidental falls (ICD E880-E888) and ischaemic heart disease (ICD 410-414 ). Conclusion. Over three-quarters of individuals aged 60 years or older who a re hospitalised with a hip fracture in New Zealand survive for at least one year after admission. However, significant variations in mortality exist w ith age and gender. These data highlight the importance of preventive strat egies for hip fracture in older people and the need to identify ways of imp roving post-admission care.