A meta-analysis of cohort studies found that older adults have a 5- to 8-fold increased risk of all-cause mortality in the first 3 months after a hip fracture. Relative hazards for mortality decreased over time but did not return to rates seen in age- and sex-matched control groups. For example, white women aged 80 with a hip fracture had excess annual mortality of 8%, 11%, 18%, and 22% at 1, 2, 5, and 10 years after injury, respectively. Men had excess annual mortality of 18%, 22%, 26%, and 20% at the same time points. Excess mortality risk was higher in men than in women at any given age. The study included 578,436 women and 154,276 men with hip fractures. Limitations include variation in study design, potential publication bias, and the use of a white U.S. population for modeling. The findings suggest that hip fracture leads to persistent excess mortality, which may be influenced by pre-existing frailty, post-fracture complications, and comorbid conditions. The study provides quantitative estimates of both relative and absolute mortality risks, which could inform cost-effectiveness analyses and treatment strategies for hip fracture prevention.A meta-analysis of cohort studies found that older adults have a 5- to 8-fold increased risk of all-cause mortality in the first 3 months after a hip fracture. Relative hazards for mortality decreased over time but did not return to rates seen in age- and sex-matched control groups. For example, white women aged 80 with a hip fracture had excess annual mortality of 8%, 11%, 18%, and 22% at 1, 2, 5, and 10 years after injury, respectively. Men had excess annual mortality of 18%, 22%, 26%, and 20% at the same time points. Excess mortality risk was higher in men than in women at any given age. The study included 578,436 women and 154,276 men with hip fractures. Limitations include variation in study design, potential publication bias, and the use of a white U.S. population for modeling. The findings suggest that hip fracture leads to persistent excess mortality, which may be influenced by pre-existing frailty, post-fracture complications, and comorbid conditions. The study provides quantitative estimates of both relative and absolute mortality risks, which could inform cost-effectiveness analyses and treatment strategies for hip fracture prevention.