Increased mortality after fracture of the surgical neck of the humerus: a case-control study of 253 patients with a 12-year follow-up.

Background: Several studies have shown a higher mortality rate in patients with osteoporosis-related fractures of the hip and vertebrae. Method: In 1999, we did a long-term follow-up case-control mortality study of 253 patients, mean age 72 years, who had sustained a fracture of the surgical neck of the humerus in 1987. Results: We found a higher mortality in fracture patients giving at end point a cumulative survival difference of 16%. The median survival time was 8.9 years in patients and 12 years in controls (pÊ= 0.005). The mortality rate was higher in men during the first 3 years after fracture and fewer than half of the male patients survived this period. The median survival time was 6.5 years in male patients and 12 years in their male controls (pÊ= 0.02). The mortality was only slightly higher in women (pÊ= 0.06). Interpretation: Cardiovascular disease and malignancy were the commonest causes of death in both groups. We could not explain the higher mortality rate in patients with a fracture of the surgical neck of the humerus.