Gender and Race/ethnicity Differences in Hip Fracture Incidence, Morbidity, Mortality, and Function

Background: Hip fracture is an international public health problem. Worldwide, approximately 1.5 million hip fractures occur per year, with roughly 340,000 in the United States in individuals older than 65 years. In 2050, there will be an estimated 3.9 million fractures worldwide, with more than 700,000 in the United States. However, whether there are disparities in morbidity, mortality, and function between men and women or between races/ethnicities is unclear.

Questions/purposes: The purpose of this article is to review the gender and racial/ethnicity differences in hip fracture epidemiology, mortality, and function and to ask what more information is needed and how can it be attained.

Methods: A PubMed literature review was performed and appropriate articles selected for inclusion in the review. WHERE ARE WE NOW?: Overall, men with hip fracture are younger, are less healthy, and have a higher postoperative mortality and morbidity. African American and Hispanics patients with hip fractures are younger than whites and have a higher incidence of fracture in men. Non-Hispanic black, Hispanic, and Asian race/ethnicity were all associated with higher odds of discharge home but a longer stay when discharged to rehabilitation. WHERE DO WE NEED TO GO?: Expanded knowledge of the influence of gender and race/ethnicity on hip fracture epidemiology, mortality, and outcomes is necessary. HOW DO WE GET THERE?: Additional focused research on gender and racial/ethnic differences in patients with hip fractures is needed. Improving database capture of race/ethnicity data will aid in population studies. Finally, journal editors should require authors to include gender and race/ethnicity data or explain the absence of this information.