BACKGROUND: Little information is available on hip fracture risks among community-dwelling persons receiving home care. Our aim was to identify risk factors for hip fracture from health information routinely collected for older home care clients. METHODS: This was a cohort study involving secondary analysis of data on 40,279 long-stay (>60 days) home care clients aged 65 and older in Ontario, Canada; occurrence of hip fracture as well as potential risk factor information were measured using the Resident Assessment Instrument (RAI)/Minimum Data Set-Home Care assessment instrument. RESULTS: In all, 1,003 clients (2.5%) had hip fracture on follow-up assessment. Older (85+ vs 65-74, relative risk [95% confidence interval]: 0.52 [0.43-0.64]) clients are at increased risk; males are at reduced risk [0.60 (0.51-0.70)]. Other risk factors include osteoporosis (1.19 [1.03-1.36]), falls (1.31 [1.15-1.49]), unsteady gait (1.18 [1.03-1.36]), use of ambulation aide (1.39 [1.21-1.59]), tobacco use (1.42, [1.13-1.80]), severe malnutrition (2.61 [1.67-4.08]), and cognitive impairment (1.30 [1.12-1.51]). Arthritis (0.86 [0.76-0.98]) and morbid obesity (0.34 [0.16-0.72]) were associated with reduced risk. Males and females demonstrated different risk profiles. CONCLUSIONS: Important risk factors for hip fracture can be identified from routinely collected data; these could be used to identify at-risk clients for further investigation and prevention strategies.
BACKGROUND: Little information is available on hip fracture risks among community-dwelling persons receiving home care. Our aim was to identify risk factors for hip fracture from health information routinely collected for older home care clients. METHODS: This was a cohort study involving secondary analysis of data on 40,279 long-stay (>60 days) home care clients aged 65 and older in Ontario, Canada; occurrence of hip fracture as well as potential risk factor information were measured using the Resident Assessment Instrument (RAI)/Minimum Data Set-Home Care assessment instrument. RESULTS: In all, 1,003 clients (2.5%) had hip fracture on follow-up assessment. Older (85+ vs 65-74, relative risk [95% confidence interval]: 0.52 [0.43-0.64]) clients are at increased risk; males are at reduced risk [0.60 (0.51-0.70)]. Other risk factors include osteoporosis (1.19 [1.03-1.36]), falls (1.31 [1.15-1.49]), unsteady gait (1.18 [1.03-1.36]), use of ambulation aide (1.39 [1.21-1.59]), tobacco use (1.42, [1.13-1.80]), severe malnutrition (2.61 [1.67-4.08]), and cognitive impairment (1.30 [1.12-1.51]). Arthritis (0.86 [0.76-0.98]) and morbid obesity (0.34 [0.16-0.72]) were associated with reduced risk. Males and females demonstrated different risk profiles. CONCLUSIONS: Important risk factors for hip fracture can be identified from routinely collected data; these could be used to identify at-risk clients for further investigation and prevention strategies.
Authors: J P Hirdes; B E Fries; J N Morris; K Steel; V Mor; D Frijters; S LaBine; C Schalm; M J Stones; G Teare; T Smith; M Marhaba; E Pérez; P Jónsson Journal: Healthc Manage Forum Date: 1999
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Authors: W P Olszynski; G Ioannidis; R J Sebaldt; D A Hanley; A Petrie; J P Brown; R G Josse; T M Murray; C H Goldsmith; G F Stephenson; A Papaioannou; J D Adachi Journal: BMC Musculoskelet Disord Date: 2002-10-03 Impact factor: 2.362
Authors: Ernst J Müller; Ingeborg Gerstorfer; Peter Dovjak; Bernhard Iglseder; Georg Pinter; Walter Müller; Katharina Pils; Peter Mikosch; Michaela Zmaritz; Monique Weissenberger-Leduc; Markus Gosch; Heinrich W Thaler Journal: Wien Med Wochenschr Date: 2013-11-08
Authors: Anne J H Vochteloo; Boudewijn L S Borger van der Burg; Maarten A Röling; Diederik H van Leeuwen; Peter van den Berg; Arthur H P Niggebrugge; Mark R de Vries; Wim E Tuinebreijer; Rolf M Bloem; Rob G H H Nelissen; Peter Pilot Journal: Arch Orthop Trauma Surg Date: 2012-04-24 Impact factor: 3.067