Post-hip fracture use of prescribed calcium plus vitamin D or vitamin D supplements and anti-osteoporotic drugs are associated with lower mortality.
A nationwide study in Finland.
J Bone Miner Res. 2011 Feb 23. doi: 10.1002/jbmr.375.
Nurmi-Lüthje I, Sund R, Juntunen M, Lüthje P.
Center for Injury and Violence Prevention, Health Center of Kouvola, FI-45100 Kouvola, Finland; Hjelt Institute, Department of Public Health, FI-00014 Helsinki University, Finland. ilona.nurmi at pp.inet.fi.
We previously found a positive association between calcium plus vitamin D and anti-osteoporotic drugs and survival among hip fracture patients. Our aim was to verify this observation using a nationwide database. A retrospective cohort of home-discharged hip fracture patients aged ?50 years (n?=?23 615) was enrolled from the national database. Primary exposure was medical treatment for osteoporosis and the outcome was all-cause mortality. Cumulative mortalities were calculated by using the Kaplan-Meier estimator. The relationship between mortality and medication purchases was modeled using Cox's proportional hazards regression with time-dependent covariates for medication use. One in four women and one in ten men with a hip fracture were treated for osteoporosis in Finland. Unadjusted one-year mortality was lower among patients who purchased calcium plus vitamin D or vitamin D supplements and anti-osteoporotic drugs than among those who did not purchase these medications (HR 0.74; 95% CI 0.67-0.81).
The difference in unadjusted cumulative mortality remained in favor of the drug users for at least five years.
Among men the use of calcium plus vitamin D or vitamin D supplements was associated with lower one-year mortality even after adjustments for observed confounders (HR 0.74; 95% CI 0.56-0.97).
Among women the use of anti-osteoporotic drugs was associated with lower mortality (HR 0.79; 95% CI 0.67-0.93).
There was a tendency to even better survival in both genders if calcium plus vitamin D or vitamin D supplements and anti-osteoporotic drugs were used simultaneously, HR being 0.72 (95% CI 0.50-1.03) in men and 0.62 (95% CI 0.50-0.76) in women. © 2011 American Society for Bone and Mineral Research.
Copyright © 2011 American Society for Bone and Mineral Research. PMID: 21351147
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