Type 2 Diabetes Increases Complications and Mortality After Hip Fracture in Older Adults: Study
Hong Kong: A large study involving 52,472 patients aged 60 years and older with hip fractures has found that 34.6% had type 2 diabetes mellitus (T2DM).
The analysis showed that T2DM independently increased the risk of cardiovascular, renal, and infectious complications during hospitalization and was associated with a modest increase in 1-year mortality (HR 1.08). Healthcare costs were 4.6% higher among patients with T2DM, while previously undiagnosed T2DM increased the risk of complications by 24.5%. However, T2DM did not affect the use of anti-osteoporosis therapy or the risk of recurrent fractures. These findings highlight the importance of early diabetes detection and optimized metabolic management in elderly patients with hip fractures.
The findings were published in Diabetes, Obesity and Metabolism by Xincheng Zou from The University of Hong Kong and colleagues.
Hip fractures are a major cause of disability, hospitalization, and death among older adults. Previous studies have established that people with type 2 diabetes are at a greater risk of sustaining hip fractures, but less is known about how diabetes influences recovery and clinical outcomes after the fracture occurs. To address this gap, the researchers investigated whether T2DM affects complications, mortality, healthcare utilization, and long-term outcomes following hip fractures in older adults.
For this purpose, the researchers analyzed territory-wide electronic health records from Hong Kong, including adults aged 60 years or older hospitalized with hip fractures between 2011 and 2020. Patients were classified by diabetes status and followed until study outcomes, death, or December 2023. The study evaluated in-hospital complications, mortality, length of stay, healthcare costs, anti-osteoporosis treatment, and recurrent fractures, with a separate analysis of patients with previously undiagnosed diabetes.
The analysis included 52,472 patients with hip fractures, of whom 34.6% had pre-existing type 2 diabetes.
The key findings included:
- T2DM independently increased the risk of cardiovascular, kidney, and infectious complications during hospitalization.
- Patients with T2DM had an 8% higher risk of death within one year after hip fracture (adjusted HR 1.08).
- In-hospital mortality and length of hospital stay were similar between patients with and without T2DM.
- Hospitalization costs were 4.6% higher among patients with T2DM.
- Patients with previously undiagnosed T2DM had an even greater risk of in-hospital complications and mortality.
- Undiagnosed T2DM was associated with 24.5% higher healthcare costs.
- T2DM did not influence the rate of anti-osteoporosis treatment or the risk of recurrent hip fractures.
The researchers concluded that type 2 diabetes is associated with poorer outcomes and a greater healthcare burden after hip fracture in older adults. They emphasized that timely diagnosis and optimal management of diabetes, together with early assessment and treatment of bone fragility, may help improve outcomes in this vulnerable population.
Reference:
DOI:10.1111/dom.71000
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