On average, second hip fractures occurred 2 years and 8 months after the primary hip fracture. Females had a higher incidence of second hip fracture. The overall incidence of a second fracture was 0.88% at 6 months, 1.81% at 1 year, 6.91% at 5 years and 9.95% at 10 years. A total 75% of second fractures occurred within around 4 years after the initial fracture.
The median survival after single fracture was 4 years 10 months, while second fracture was 3 years 8 months. Lower survival was observed in second fracture (HR 5.44, 95%CI 1.67-11.1, p<0.001) and in males (HR 1.91, 95%CI 1.86-1.96, p<0.05). Older patients had a minimal risk for increase mortality (HR 1.061, 95%CI 1.059-1.063, p<0.05).
The authors concluded that further studies are needed to help explain the excessive mortality of second hip fracture compared to primary hip fractures. Furthermore, they suggest that early initiation of treatment and a fragility fracture prevention programme after primary hip fracture could help reduce second fracture incidence and related mortality.