Table 3.
Post-hip fracture admission mortality in CKD, both (a) all-cause mortality and (b) hip fracture-related mortality
| Renal status | Total with hip fracture | Events, n | PY follow-up (1000) | Rate per 1000 PY (95% CI) |
Unadjusted MRR (95% CI) |
Adjusted* MRR (95% CI) final model |
| (a) All-cause mortality post-hip fracture | ||||||
| CKD stages 3–5† | 915 | 666 | 1.4 | 488.0 (452.4 to 526.6) | 1.58 (1.26 to 1.99) | 1.09 (0.85 to 1.39) |
| CKD stage 5b† | 2 | 2 | 0.0 | 764.1 (191.1 to 3055.3) | 2.47 (0.61 to 10.06) | 1.04 (0.24 to 4.51) |
| CKD stage 4 | 77 | 71 | 0.1 | 885.3 (701.6 to 1117.1) | 2.87 (2.09 to 3.93) | 2.04 (1.44 to 2.89) |
| CKD stage 3b | 320 | 240 | 0.4 | 542.2 (477.7 to 615.3) | 1.76 (1.37 to 2.25) | 1.11 (0.85 to 1.45) |
| CKD stage 3a | 516 | 353 | 0.8 | 420.7 (379.0 to 466.9) | 1.36 (1.07 to 1.73) | 1.02 (0.80 to 1.32) |
| Normal eGFR | 161 | 83 | 0.3 | 308.9 (249.1 to 383.0) | 1.00 (Reference) | 1.00 (Reference) |
| (b) Hip fracture mortality post-hip fracture | ||||||
| CKD stages 3–5† | 915 | 183 | 1.4 | 134.1 (116.0 to 155.0) | 1.39 (0.92 to 2.09) | 0.79(0.51 to 1.22) |
| CKD stage 5† | 2 | 0 | 0.0 | – | – | – |
| CKD stage 4 | 77 | 24 | 0.1 | 299.3 (200.6 to 446.5) | 3.09 (1.78 to 5.39) | 1.88 (1.02 to 3.47) |
| CKD stage 3b | 320 | 72 | 0.4 | 162.7 (129.1 to 204.9) | 1.68 (1.07 to 2.63) | 0.85 (0.53 to 1.37) |
| CKD stage 3a | 516 | 87 | 0.8 | 103.7 (84.0 to 127.9) | 1.07 (0.69 to 1.66) | 0.71 (0.45 to 1.12) |
| Normal eGFR | 161 | 26 | 0.3 | 96.8 (65.9 to 142.1) | 1.00 (Reference) | 1.00 (Reference) |
The number of hip fracture deaths are not the same in tables 3b and 2b because:
1. Four individuals with CKD stages 3–5 died on date of hip fracture admission and are not included in the number of deaths in table 3.
2. A further 15 individuals had no record of a hip fracture admission but had a hip fracture-related death, and are therefore not included in the population for post-hip fracture mortality. Of these, 11 had CKD stages 3–5, with an average age of 87. Some died within a few days of index date. They had multiple and varied other causes of death, hip fracture was not the first or second cause for any. Four had normal eGFR, with an average age of 86. All died within 3 days of index date, and did not have hip fracture recorded as first, second or third cause of death.
*Adjusted for age, sex, Charlson Comorbidity Index score, deprivation, proteinuria and rurality (all variables remained in model).
†CKD stage 5 does not include dialysis or transplants.
CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; MRR, mortality rate ratio; PY, patient-years.