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dc.contributor.authorHolvik, Kristin
dc.contributor.authorHjellvik, Vidar
dc.contributor.authorKarlstad, Øystein
dc.contributor.authorGunnes, Nina
dc.contributor.authorHoff, Mari
dc.contributor.authorTell, Grethe Seppola
dc.contributor.authorMeyer, Haakon Eduard
dc.date.accessioned2022-06-30T08:55:40Z
dc.date.available2022-06-30T08:55:40Z
dc.date.created2022-05-09T16:48:16Z
dc.date.issued2022
dc.identifier.issn2044-6055
dc.identifier.urihttps://hdl.handle.net/11250/3001723
dc.description.abstractObjectives Patients with hip fracture are typically characterised by extensive comorbidities and excess mortality. Methods that account for a wide range of comorbidities are needed when attempting to identify causal associations in registry-based studies. We aimed to study the association between the prescription-based Rx-Risk Comorbidity Index (abbreviated Rx-Risk) and mortality by history of hip fracture, and to quantify the contribution of Rx-Risk in explaining the excess mortality after hip fracture. Setting In this prospective study, we used nationwide registry data from outpatient care. Rx-Risk was based on filled prescriptions recorded in the Norwegian Prescription Database. Medications were mapped to 46 comorbidity categories by Anatomical Therapeutic Chemical code. Information on hip fractures during 1994–2013 was available from the Norwegian Epidemiologic Osteoporosis Studies hip fracture database, and year of death was obtained from Statistics Norway. We estimated 1-year mortality risk (January through December 2014) according to Rx-Risk score based on dispensed prescriptions in 2013, history of hip fracture, age and sex using Poisson regression. Participants All individuals aged 65 years and older who were alive by the end of 2013 and had filled at least one prescription in an outpatient pharmacy in Norway in 2013 (n=735 968). Results Mortality increased exponentially with increasing Rx-Risk scores, and it was highest in persons with a history of hip fracture across the major range of Rx-Risk scores. Age- and sex-adjusted mortality risk difference according to history of hip fracture (yes vs no) was 4.4 percentage points (7.8% vs 3.4%). Adjustment for Rx-Risk score further attenuated this risk difference to 3.3 percentage points. Conclusions History of hip fracture and comorbidity assessed by Rx-Risk are independent risk factors for mortality in the community-dwelling older population in Norway. Comorbidity explained a quarter of the excess mortality in persons with a history of hip fracture.en_US
dc.language.isoengen_US
dc.publisherBMJ Publishing Groupen_US
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/deed.no*
dc.subjectRegisterstudieren_US
dc.subjectRegistry studiesen_US
dc.subjectLegemiddelbruken_US
dc.subjectDrug useen_US
dc.subjectForskningsmetoderen_US
dc.subjectReseach methodsen_US
dc.subjectEpidemiologien_US
dc.subjectEpidemiologyen_US
dc.titleContribution of an extensive medication-based comorbidity index (Rx-Risk) in explaining the excess mortality after hip fracture in older Norwegians: a NOREPOS cohort studyen_US
dc.title.alternativeContribution of an extensive medication-based comorbidity index (Rx-Risk) in explaining the excess mortality after hip fracture in older Norwegians: a NOREPOS cohort studyen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright Author(s) (or their employer(s)) 2022.en_US
dc.source.articlenumbere057823en_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1
dc.identifier.doi10.1136/bmjopen-2021-057823
dc.identifier.cristin2022842
dc.source.journalBMJ Openen_US
dc.subject.nsiVDP::Epidemiologi medisinsk og odontologisk statistikk: 803en_US
dc.subject.nsiVDP::Epidemiology, medical and dental statistics: 803en_US
dc.identifier.citationBMJ Open. 2022, 12 (5), e057823.en_US
dc.source.volume12en_US
dc.source.issue5en_US


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Navngivelse-Ikkekommersiell 4.0 Internasjonal
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