For Older Adults, Breaking a Hip Can Be Deadlier Than Cancer

Breaking a hip is a common fear in older adults. It’s linked to a long recovery period and even death in an older population. New research is validating and quantifying that fear, showing that survival rates post-hip fracture can be lower than those for several cancers.

The research, published in JBMR Plus, examined health data from nearly 100,000 Canadians aged 65 and older, finding that hip fractures resulted in the poorest outcomes. Less than one-third of affected men and half of the affected women survived for five years post-fracture. The oldest demographic, people over 85, faced the worst prognosis.

The study noted that while women generally had better post-fracture outcomes than men, they were also at a higher risk of experiencing fractures initially.

Overall, the researchers discovered that patients were at the highest risk of dying in the initial month after they had a fracture. But doctors say that dying from a hip fracture is less about the bone break itself and more about what can happen next. Here’s what you need to know.

How Common Is It to Die After Breaking a Hip?

All osteoporosis-related fractures in older patients are associated with lower five-year survival rates, study coauthor Jacques P. Brown, MD, professor of medicine at Laval University, told Verywell.

“But hip fracture is the worst-case scenario, where at least 30% of people will die over a year,” he said.

The first month is usually the hardest. Even so, “those who survive the first month will have low survival rates over five years compared to the same-aged population,” Brown said.

Why Is Breaking a Hip So Deadly?

Hip fractures are particularly dangerous because they require a period of immobility, which can lead to complications such as blood clots, muscle atrophy, infections, and heart failure. Barbara Bawer, MD, a family medicine physician at The Ohio State University Wexner Medical Center, told Verywell that restrictions on mobility increase the risk of depression, further deteriorating overall health outcomes.

But having a hip fracture can also signal that something else is going on with a person’s health, Alex Jahangir, MD, professor of orthopedic surgery and director of the division of orthopedic trauma at Vanderbilt University Medical Center, told Verywell.

“If a younger person falls, they’re unlikely to break a hip because they’re usually healthy,” he said. “But breaking a hip in the elderly is usually a result of comorbidities.”

When an older person breaks a hip, they’re usually bed-bound as they recover and health can “further degenerate,” Jahangir said. “They’re not going to be as strong, and balance will be harder to regain,” he said. “It starts this downward spiral of losing independence.”

A 30% mortality rate within a year is “pretty high,” Jahangir said, adding, “I don’t know many cancers that have that high of a mortality rate within a year.”

What Might Predispose Someone to Poor Outcomes?

There are a few factors that will raise the risk of a poor outcome after a fracture.

“Having underlying conditions prior to a fall would lead to worsening outcomes,” Bawer said, listing heart failure, heart disease, osteoporosis, lung disease, and bleeding or clotting disorders as prime examples.

But Brown also discovered that most of the people who had hip fractures were discharged from the hospital without any type of treatment to help them avoid another fracture in the future.

“About 40% of those people will have a second fracture over five years,” he said. “We have to take action when those people are still in the hospital.”

Many hip fracture patients are discharged after four to six weeks, a time period that Brown considers a “window of opportunity” to prevent fractures.

“There have been a lot of new drugs that, if used, we could prevent at least half of those recurring fractures and have people living longer,” he said.

How Can You Improve Your Chances of a Good Outcome After Breaking a Hip?

Bawer stresses the importance of getting evaluated by a medical provider and receiving treatment if you suspect or know that you have a hip fracture.

“Staying positive, attending regular follow-ups and physical therapy is also important,” she said. “Staying as active as possible is key and as early as possible, as well as eating a well-balanced diet.”

Compression stockings can help reduce your risk of blood clots. Some people also benefit from taking a baby aspirin, Bawer said.

“To prevent pressure ulcers and infections from occurring during the initial immobility state, frequent changes in position every two hours is important, as well as a soft mattress,” she said.

You’ll also want to fall-proof your space as much as possible. For instance, make sure rugs are secure to avoid tripping.