TOPLINE:

Patients with proximal humerus fractures demonstrated substantially higher mortality rates than their matched control individuals from the general population over a 2-year period, with the highest risk seen in the first 30 days post-fracture and consistently high rates seen in men than in women.

METHODOLOGY:

• Researchers conducted a population-based matched cohort study to assess all-cause mortality among adults with proximal humerus fractures in Denmark.
• This study used data gathered from the Danish National Patient Register and Danish Civil Registration System from 1998 to 2018 spanning 21 years and included 93,952 patients with proximal humerus fracture (mean age, 67 years; 69% women) and 469,760 age- and sex-matched control individuals from the general population.
• Outcome measures encompassed all-cause death episodes at 30 and 90 days and 1 and 2 years after the index date of fracture.

TAKEAWAY:

• Mortality rates were significantly higher among patients with proximal humerus fracture (1.8%-6.1%) than among matched control individuals (0.3%-3.9%) across all time periods, with consistently higher rates being observed in men than in women.
• Among patients aged 90 years or older, the highest mortality rates were observed at 366-730 days post-fracture, with mortality rates of 395.08 per 1000 persons for men and 275.18 per 1000 persons for women.
• In the age group of 60-69 years, mortality rate ratios were particularly high within 30 days post-fracture, with men showing a mortality rate ratio of 16.32 (95% CI, 14.47-18.40) and women showing a mortality rate ratio of 7.82 (95% CI, 7.15-8.54).
• Between days 31 and 90, mortality rate ratios decreased to 6.75 (95% CI, 6.07-7.52) for men and 3.87 (95% CI, 3.58-4.19) for women in the age group of 60-69 years; the rates decreased further between 90 and 365 days before stabilising.

IN PRACTICE:

"The high MRRs [mortality rate ratios] observed during the early post-fracture period raise the question of whether certain subgroups, particularly male PHF [proximal humerus fracture] patients, may benefit from more structured follow-up or early geriatric assessment, which could potentially contribute to reducing excess mortality," the authors wrote.

SOURCE:

This study was led by Helle Kvistgaard Østergaard, Department of Orthopaedics, Viborg Regional Hospital, Viborg, Denmark. It was published online on August 22, 2025, in Osteoporosis International.

LIMITATIONS:

Data on the cause of death and comorbidities were lacking.

DISCLOSURES:

Open access funding was provided by the Central Region of Denmark. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.