Hip fracture linked to higher mortality risk
SINGAPORE – Hip fracture patients are twice as likely to die from cancer, coronary heart disease and other prime causes of death here, according to data collected in the Singapore Chinese Health Study (SCHS).
Doctors involved in analysing the data are urging people to fight osteoporosis – a condition by which bones lose density and become weak – and take extra precautions when immobile.
There are probably around 1,000 cases of hip fracture a year now, said Associate Professor Wilson Wang, head of hip and knee surgery orthopaedics at National University Hospital.
“But it’s certainly something that is going to grow in the coming years because of our ageing population.”
The SCHS monitored more than 63,000 Chinese between 45 and 74 years old from 1993 to 1998, and the raw data is still being looked at.
A sample size of 1,166 hip fracture patients were isolated from the study.
It was found that stroke, pneumonia and urinary tract infection fatalities were double in the hip fracture cases examined compared to non-hip fracture cases.
Hip fracture patients were also more likely to die from cancer and coronary heart disease.
“Women with hip fractures were more likely to die from urinary tract infection, and men from heart disease or pneumonia,” said Associate Professor Gerald Koh, of the National University of Singapore’s Saw Swee Hock School of Public Health.
The higher risk of mortality can be attributed to long periods of immobility, experts said.
“When you’re not so mobile, you tend to retain urine and it provides an opportunity for bacteria to multiply exponentially and increases the risk of a urinary tract infection,” said Prof Koh.
“For these patients who don’t have surgery and are lying there for a long time because they’re waiting for their wound to heal, they may develop more complications such as chest infections.”
Aspiration pneumonia is caused by food in the lungs and could result from a patient spending long periods lying down.
It is important to avoid lying down for too long, said Prof Wang.
For Mr Tan Say Bee, 47, rehabilitation exercises that he learnt to improve his mobility when he suffered a stroke are helping him cope with a recent hip fracture.
“You definitely have to take deep breaths regularly, keep your system going. I raise my legs and arms slowly all the time,” said the wheelchair-bound former dishwasher.
While rehabilitation helps, preventing hip fractures is key.
“The best way is to stop osteoporosis,” said Prof Koh.
HOW TO PREVENT OSTEOPOROSIS
- Weight-bearing exercises such as running, jogging and walking are good for bone strength.
- Women should get checked for osteoporosis before reaching menopause as bone density treatments will be more effective then.
- Get enough calcium – 800mg a day – in your diet. Natural sources such as milk, soya bean milk and spinach are favourable.
- Get enough vitamin D as well. The current dietary recommendation is 200 IU a day.
- Avoid smoking and excessive alcohol. Chemicals in cigarettes are harmful to bone cells. In women, smoking can prevent oestrogen from protecting bones. Excessive drinking can reduce bone formation.
Input from Health Promotion Board, Associate Professor Gerald Koh and Associate Professor Wilson Wang.
Source: The Straits Times
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