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Mortality, Disability, And Nursing Home Use For Persons With And Without Hip Fracture: A Population-based Study.

Cynthia L. Leibson, Anna Tosteson, Sherine E. Gabriel, Jeanine E. Ransom, L. Joseph Iii Melton
Published 2002 · Medicine
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OBJECTIVES To compare persons with and without hip fracture for subsequent mortality and change in disability and nursing home (NH) use. DESIGN Population-based historical cohort study. SETTING Olmsted County, Minnesota. PARTICIPANTS All residents who experienced a first hip fracture between January 1, 1989, and December 31, 1993, and, for each case, a resident of the same sex and similar age who had not experienced a hip fracture and was seen by a local care provider. MEASUREMENTS Data on disability (Rankin score), comorbidity (Charlson Index), and NH residency before baseline (fracture date for cases and registration date for controls) were obtained by review of complete community-based medical records. The records were then reviewed from baseline through December 31, 1994, for Rankin disability at 1 month and 1 year, all NH admissions and discharges, and date of death for those who died. RESULTS There were 312 cases and 312 controls (81% female, mean age +/- standard deviation = 81 +/- 12 years). Before baseline, cases had higher comorbidity (45% vs 30% had Charlson Index >/= 1, P <.001) and disability (mean Rankin score = 2.5 +/- 1.1 vs 2.2 +/- 1.1, P <.001) and were more likely to be in a NH (28% vs 18%, P <.001) than controls. One year after baseline, estimated mortality was 20% (95% confidence interval (CI) = 16-24) for cases vs 11% (95% CI = 8-15) for controls, 51% of cases versus 16% of controls had a level of disability one or more units worse than before baseline (P <.001), and the cumulative incidence of first NH admission was 64% (95% CI = 58-71) for cases versus 7% (95% CI = 4-11) for controls. The risk of NH admission for cases relative to controls diminished over time, but remained elevated 5 years after the event (risk ratio = 20.0 at 3 months and 2.1 at 5 years), but, in persons admitted to a nursing home, cases were two times more likely than controls to be discharged alive within a year (P <.001). CONCLUSIONS Hip fracture is an important contributor to disability and NH use, but the potential savings from hip fracture prophylaxis may be overestimated by studies that fail to consider differential risk, mortality, and long-term follow-up.



This paper is referenced by
10.1016/j.injury.2019.09.039
Outcomes of elderly patients with nondisplaced or minimally displaced femoral neck fractures treated with internal fixation: A systematic review and meta-analysis.
Archie L Overmann (2019)
10.1186/1471-2474-15-188
The development of a comprehensive multidisciplinary care pathway for patients with a hip fracture: design and results of a clinical trial
Elvira R Flikweert (2014)
10.1016/B978-1-4377-0416-7.00027-5
Influence of Systemic Conditions on the Periodontium
Perry R. Klokkevold (2012)
10.1007/s00337-011-0880-5
Balance-Retraining
Elisabeth Preisinger (2011)
Chronic PPI Therapy and Calcium Metabolism
Yaning Yang (2015)
10.3390/ijerph15020289
Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents
Hannes Jacobs (2018)
The development and application of a normative framework for considering uncertainty and variability in economic evaluation
Douglas Coyle (2004)
Obesity, bariatric surgery, and bone strength: a review and studies in adult cohorts.
Lesley M. Scibora (2011)
10.2106/JBJS.H.01204
Ninety-day mortality after intertrochanteric hip fracture: does provider volume matter?
Mary L. Forte (2010)
10.1016/j.beem.2014.04.005
Identification of patient profile for treatment.
Rebecca Jane Moon (2014)
10.1111/ans.13429
Impact of malnutrition on 12-month mortality following acute hip fracture.
Jack J Bell (2016)
10.1038/srep23360
Chronic Obstructive Pulmonary Disease Increases the Risk of Hip Fracture: A Nationwide Population-Based Cohort Study
S. Huang (2016)
STUDENTS: UTILIZATION OF THE HEALTH BELIEF MODEL
E. Edmonds (2009)
10.1590/S1679-45082018AO4236
Fracture risk assessment in home care patients using the FRAX® tool
Vitor Moraes Rocha (2018)
10.1007/s00508-009-1216-5
Prevalence of vertebral fracture in elderly men and women with osteopenia
Christian Muschitz (2009)
10.1007/s00198-005-1949-6
Health-related quality of life measurements in elderly Canadians with osteoporosis compared to other chronic medical conditions: a population-based study from the Canadian Multicentre Osteoporosis Study (CaMos)
Anna M Sawka (2005)
10.1080/14606925.2019.1595423
Designing better hip protectors: a critical and contextual review examining their acceptance and adoption in older populations
Simon R. Andrews (2019)
10.3945/jn.110.135806
Dietary acid load is not associated with lower bone mineral density except in older men.
Robert R Mclean (2011)
10.2217/AHE.13.43
Diagnosis and treatment of bisphosphonate-induced atypical femoral fractures
Michelle S Abghari (2013)
10.12968/BJCN.2012.17.5.206
Thinking falls-taking action: a falls prevention tool for care homes.
Kate S. Robertson (2012)
10.1016/j.jamda.2010.12.001
Prevalence of dementia and cognitive impairment among older adults with hip fractures.
Dallas P Seitz (2011)
10.1111/j.1542-2011.2010.00003.x
New treatment approach for osteopenia.
Gillian G. Tufts (2011)
10.1016/S0020-1383(16)30014-6
Medical management of osteoporosis and the surgeons' role.
Melvin Paul Rosenwasser (2016)
10.1136/ip.2010.029579
Review of the long-term disability associated with hip fractures
Melanie Y. Bertram (2011)
10.1517/14656566.2011.618123
Current options for the management of postmenopausal osteoporosis
Marie-Paule Lecart (2011)
10.1097/BOT.0b013e3182a5a045
Orthogeriatric Care Models and Outcomes in Hip Fracture Patients: A Systematic Review and Meta-Analysis
Konstantin V Grigoryan (2014)
Does health status matter for the risk of injury?
Ruth Cunningham (2010)
10.1002/jbmr.235
BMI and Fracture Risk in Older Men: The Osteoporotic Fractures in Men Study (MrOS)
Carrie M Nielson (2011)
10.1186/1471-2458-6-87
Patients with femoral or distal forearm fracture in Germany: a prospective observational study on health care situation and outcome
Heinz G. Endres (2006)
10.1007/s11657-019-0642-x
What are the influencing factors in self-rated health status after hip fracture? A prospective study on 402 patients
Juliana Hack (2019)
10.1002/jbmr.2180
The potential economic benefits of improved postfracture care: a cost-effectiveness analysis of a fracture liaison service in the US health-care system.
Daniel H. Solomon (2014)
10.1111/jgs.14162
Antipsychotic Drugs and Risk of Hip Fracture in People Aged 60 and Older in Norway.
M. Bakken (2016)
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