Risk of Death in Elderly Korean Patients with Skeletal Fracture: The National Health Insurance Service-National Sample Cohort Study

Background: The aim of this study was to assess the risk of death for elderly Korean patients with fracture of the lumbar spine and pelvis, femur, or limbs due to few studies about risk of death in elderly Korean patients with fracture. Methods: Older patients (>= 65 years) were diagnosed as part of the Korean National Health Insurance Service - National Sample Cohort from 2002 through 2013. Results: The proportion of deaths was 23.1% in the lumbar spine and pelvis fracture group, 42.3% in the femur fracture group, and 13.5% in the limb fracture group (p < 0.001). For risk of death with lumbar spine and pelvis fracture, the hazard ratio (HR) after adjustment for age, sex, income level, and season was 2.16 for the 75 to 84 year-old, 3.93 for the 85-year or older, 1.91 for males, and 1.15 and 1.14 in middle and lower income, respectively. The adjusted HR of femur fracture was 1.62 for the 75 to 84 year-old, 2.71 for the 85-year or older, 1.35 for males, 1.14 for middle income, and 1.14 for autumn, and 1.19 for summer. The adjusted HR of limb fracture was 2.77 for the 75 to 84 year-old, 7.15 for the 85-year or older, 1.64 for males, 1.20 for middle income, 1.15 for lower income, 1.14 for autumn, 1.10 for summer, and 1.10 for spring. Conclusions: Older age, male sex, relatively lower income level, and seasons were associated with death in elderly Korean patients with skeletal fracture. Copyright (C) 2020, Taiwan Society of Geriatric Emergency & Critical Care Medicine.