The occurrence of a low energy fracture of the distal radius increases the risk for another more serious fracture such as a proximal femoral fracture. to the distal radial fracture or its treatment. Level of Evidence: III mortality rate after DRF than the general population. The mortality rate did not vary significantly based on the time from injury (Table 2). Figure 1 Mortality rate for Medicare beneficiaries diagnosed with a distal radius fracture in 2007 and an PD0325901 age-and sex-matched general United States population. (a) Male. (b) Female. Table PD0325901 1 Demographic analysis of the Medicare distal radial fracture cohort. Table 2 Mortality rate by time since isolated distal radial fracture. Female sex was associated with a significantly decreased risk of death (Hazard ratio (HR) 0.77) (Table 3). Beneficiaries who were Asian American Indian Alaskan Native Hawaiian Native or Pacific Islander had a decreased risk of death in comparison with white beneficiaries (HR 0.83). Beneficiaries who were treated operatively also had a decreased risk of death. Table 3 Risk of death by patient and treatment factors. DISCUSSION Our study demonstrates that there is no increased risk of mortality to Medicare beneficiaries after a DRF and in fact mortality is lower than that of the general US population. This is not an unexpected finding and may be due to regular visits with a healthcare provider after DRF that may allow other conditions which may contribute to mortality to be identified and treated (Morin et al. 2011 Shortt and Robinson 2005 Additionally the mortality rate of the cohort did not vary as the time from fracture increased. Mortality is thought to be attributable to a particular event if it is highest immediately after the event and then tapers off gradually (Johnell et al. 2004 This pattern of mortality is typically seen after proximal femoral fracture (Bass et al. 2007 Ioannidis et al. 2009 Melton et al. 2013 Morin et al. 2011 In the DRF cohort the mortality rate was lowest in the year of fracture perhaps attributable to the aforementioned involvement with healthcare and then remained steady for 5 years after fracture. This suggests that any mortality after DRF is unlikely to be attributable to the fracture or its treatment. Although there was no general increase in mortality within the cohort there were groups that were more at risk. Beneficiaries who were older and those with more comorbidities were at a higher risk of death. Male beneficiaries were also at higher risk. This is likely to be because male beneficiaries had a higher mean comorbidity score at baseline. Some factors were associated with lower risk of death. Beneficiaries whose race was categorized as “other” had a lower risk of death than white beneficiaries. This may be because the “other” category was comprised largely of Asian-American and Hispanic women. Women of Asian or Hispanic descent have the two highest life expectancies of any American gender/race subgroup (Office of Minority Health 2014 Office of Minority Health 2014 Finally beneficiaries who were treated PD0325901 operatively were at lower risk of death. This is consistent with our previous findings that beneficiaries with more comorbidities are less likely to be treated by internal fixation (Chung et al. 2011 This is likely to be true for all surgical treatment methods and indicates that surgical treatments are used in PD0325901 healthier beneficiaries. Our results are counter to previous publications. Rozental et al. (2002) found decreased survival up to 7 years after fracture in an American sample comprised of the authors’ own patients aged 65 years or more. Johnell et al. (2004) examined a Swedish sample aged 60 years or more selected from records at the authors’ institution and found increased risk of death up to 5 years after fracture although this could not be attributed directly to the fracture. We set out to confirm these interesting findings. Rabbit Polyclonal to PPP1R2. We included only isolated DRFs to target low-energy osteoporotic fractures as much as possible and used Medicare data to increase the sample size and power. After these adjustments the deleterious effects of DRFs on mortality were not found. A notable limitation of this study is the lack of information about cause and manner of death. Without this information we are unable to exclude beneficiaries whose deaths were not natural. However the homicide rate for people aged 65.