Sci Rep. 2026 Jul 2. doi: 10.1038/s41598-026-60581-z. Online ahead of print.
ABSTRACT
This study investigated the incidence of fractures, 30-day and 1-year mortality risk, and primary causes of death among Taiwanese older adults. This retrospective cohort study examined data from the National Health Insurance Research Database and the Taiwan Cause of Death Statistics. The study population from 2015 to 2020 included individuals aged 65 years and older who were hospitalized for the first time because of a specific fracture. Among 3,778,382 older adults, 773,538 fracture incidences were recorded, with an overall incidence rate of 3,685.8 per 100,000 person-years. Fracture incidence was substantially higher in women than in men (5,061.2 vs. 2,344.1 per 100,000 person-years). The 30-day and 1-year mortality rates were 1.73% and 8.99%, respectively. Multivariate Cox regression analysis revealed that male sex (30 days: HR = 1.71, 95% CI 1.64-1.78; 1 year: HR = 1.68, 95% CI 1.65-1.71), advanced age (≥ 85 vs. 65-69 years; 30 days: HR = 3.83, 95% CI 3.49-4.20; 1 year: HR = 4.82, 95% CI 4.64-5.01), lower income (highest vs. lowest income: 30-day HR = 0.57, 95% CI 0.51-0.63; 1-year HR = 0.60, 95% CI 0.57-0.62), lower urbanization level (Level 7 vs. Level 1: 30 days HR = 1.27, 95% CI 1.16-1.39; 1 year HR = 1.15, 95% CI 1.11-1.19), higher comorbidity scores (CCI ≥ 3; 30 days: HR = 1.58, 95% CI 1.50-1.66; 1 year: HR = 2.20, 95% CI 2.15-2.24), and the presence of some concomitant injuries were significantly associated with increased mortality risk. Among concomitant injuries, particularly intracranial injuries (30-day HR = 4.78, 95% CI 4.51-5.07; 1-year HR = 2.13, 95% CI 2.06-2.20), cervical spine injuries (30-day HR = 2.23, 95% CI 1.70-2.93; 1-year HR = 1.76, 95% CI 1.53-2.04), and intrathoracic injuries (30-day HR = 3.35, 95% CI 3.05-3.68; 1-year HR = 1.65, 95% CI 1.56-1.75) conferred particularly high mortality risks. The leading causes of death varied by time period. Within 30 days postfracture, the most common causes of death were accidental injuries, cardiovascular diseases, and malignant neoplasms. Within 1 year postfracture, malignant neoplasms, cardiovascular diseases, and pneumonia were the most common causes. These findings indicate the importance of early mobilization and active rehabilitation in reducing complications and improving survival outcomes among older adults following fractures.
PMID:42393210 | DOI:10.1038/s41598-026-60581-z