Hip fracture outcomes and their prevention in Kanawha County, West Virginia.

Fracture of the hip is a serious and frequent problem in elderly women, often resulting in a considerable loss of function and an increased mortality long after the initial episode. By reviewing medical records coded for fracture of the proximal femur, we determined the incidence of hip fracture and the in-hospital outcomes for women ages 50 and older in Kanawha County during 1995-96. Additionally, we estimated from existing sources the potentially treatable risk factors for prevention of this malady. Our discharge outcomes showed that ambulation status, discharge to home and the mortality rate were similar to national averages; however, the incidence of hip fracture in our subjects was higher than in the most age-specific groups. Physical inactivity, impaired vision, falls, smoking, alcohol intake and a low bone mineral density were identified in our area as significantly prevalent and potentially treatable risk factors. Although hip-fracture prevention can be approached by the individual health care practitioner, community-based programs would appear to be more practical; however, little evidence currently exists to support this type of large scale intervention.