Trends in femoral neck fracture-related mortality in the United States: A nationwide retrospective study from 1999 to 2023

Femur neck fracture is a significant cause of mortality and morbidity in the U.S. This study examines the long-term temporal trends in femur neck fracture-related mortality among individuals aged ≥ 65 in the United States from 1999 to 2023. A retrospective analysis of death records listing International Statistical Classification of Diseases, Tenth Revision code S72.0 (femoral neck fracture) as the underlying cause of death was conducted using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database from 1999 to 2023. We analyzed crude and age-adjusted mortality rates (AAMRs) per 100,000 population. Joinpoint regression analysis was used to calculate annual percent changes and evaluate trends across various demographics and geographics in the U.S. Between 1999 and 2023, femur neck fractures caused 323,534 deaths among U.S. adults aged ≥ 65 years. The AAMR peaked at 39.6 in 2002 and declined to 22.4 in 2023. A significant drop occurred from 2002 to 2018 (annual percent change -3.00 P < .05). Males (30.81), Non-Hispanic (NH) Whites (34.35) and rural areas (41.47) showed the highest AAMR among their demographic and geographic counterparts. Further, among states, Montana (58.9) and Minnesota (58.8) had the highest cumulative AAMRs. Despite overall declines in mortality among individuals with femur neck fractures, persistent disparities by sex, race, and geography highlight the need for targeted prevention strategies.