Increased all-cause mortality following distal radius fractures in Danish adults: a register-based matched cohort study

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Abstract
Background and purpose: Distal radius fractures (DRFs) are common in older adults and are associated with osteoporosis and underlying frailty. While hip and spine fractures are associated with increased mortality, the association between DRFs and all-cause mortality remains less clear. We aimed to assess all-cause mortality risk following DRF in Denmark compared with age- and sex-matched controls.Methods: We conducted a nationwide, register-based matched cohort study using data from the Danish National Patient Register and Civil Registration System (1998–2018). Adults (≥ 18 years) with a DRF were matched 1:5 to controls by sex and birthdate ± 30 days. Mortality rates per 103 persons and mortality rate ratios with 95% confidence intervals (CIs) were calculated at 30, 90, 365, and 730 days after the fracture.Results: We included 190,513 patients with DRF and 952,565 controls (70% female, mean age 59 years). Mortality rates were higher for patients with DRF compared with controls across all age categories, particularly in men and within the first 30 days. Among men, mortality rates ranged from 0.36 to 52.9 per 1,000 persons in patients with DRF and from 0.07 to 20.0 per 1,000 persons in controls. Among women, mortality ranged from 0.16 to 26.3 per 1,000 persons in patients with DRF and from 0.04 to 15.9 per 1,000 persons in controls. Mortality rate ratios were highest for the 50–59 age category (male: 4.60, CI 3.95–5.35, female 3.08, CI 2.80–3.39), decreasing with higher age. Mortality rate ratios stabilized after 365 and 730 days.Conclusion: This nationwide study shows increased all-cause mortality among patients with DRF compared with sex and age-matched controls, with the highest mortality rate within the first 30 days after the fracture. The mortality rate ratio was consistently higher in the age-group 50–59 and among males.

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