European Journal of Orthopaedic Surgery & Traumatology · Oct 27, 2026

Mortality and healthcare utilization after proximal humeral fractures in patients aged 65 years and older: a register-based cohort study

By Jensen JL, Nøhr LS, Kristensen PK et al.

PURPOSE: Proximal humeral fractures are associated with substantial pain, impaired mobility, and reduced quality of life, yet no widely accepted guidelines for post-fracture care exist. This study investigates one-year mortality and identifies pre-fracture risk factors associated with mortality. Further, it examines changes in healthcare utilization and associated risk factors across hospitals, municipalities, and primary care before and after the fracture. METHODS: Patients aged ≥65 years with proximal humeral fracture were identified from the CROSS-TRACKS cohort. One-year mortality was analysed using Kaplan-Meier and Cox regression, adjusting for sex, age, Charlson Comorbidity Index (CCI), civil status, and residential status. Changes in hospital contacts, municipal services, and primary care contacts were assessed using paired t-tests, and their associations with sex, age, CCI, civil status, and residential status were examined using multiple linear regression. RESULTS: One-year mortality was 11.6% (95% confidence interval (CI) 10.8; 12.3). Male sex, older age, higher CCI, unmarried status, and nursing home residency were associated with increased mortality. From the year before to the year after the fracture, hospital contacts increased by a mean of 2.1 (95% CI: 2.0; 2.3), municipal services by 339.1 (95% CI: 294.6; 383.5), and primary care contacts by 4.4 (95% CI: 3.9; 4.8). Older age and higher CCI were associated with increased healthcare utilization. CONCLUSION: Patients with proximal humeral fractures had high one-year mortality and increased healthcare utilization. Older age and high CCI were associated with both outcomes. These findings highlight the need for standardized, evidence-based protocols with patient-centred principles for this frail population.

doi.org/10.1007/s00590-026-05016-1PubMed 42944935Populations