Recent hospitalization and the risk of hip fracture among older Americans.

TitleRecent hospitalization and the risk of hip fracture among older Americans.
Publication TypeJournal Article
Year of Publication2009
AuthorsWolinsky, FD, Bentler, SE, Liu, L, Obrizan, M, Cook, EA, Wright, KB, Geweke, JF, Chrischilles, EA, Pavlik, CE, Ohsfeldt, RL, Jones, MP, Richardson, KK, Rosenthal, GE, Wallace, RB
JournalJ Gerontol A Biol Sci Med Sci
Date Published2009 Feb
ISSN Number1758-535X
KeywordsAccidental Falls, Age Distribution, Aged, Aged, 80 and over, Aging, Cohort Studies, Female, Follow-Up Studies, Geriatric Assessment, Hip Fractures, Hospitalization, Humans, Logistic Models, Male, Multivariate Analysis, Probability, Proportional Hazards Models, Prospective Studies, Risk Factors, Sex Distribution, Survival Analysis, United States

BACKGROUND: We identified hip fracture risks in a prospective national study.

METHODS: Baseline (1993-1994) interview data were linked to Medicare claims for 1993-2005. Participants were 5,511 self-respondents aged 70 years and older and not in managed Medicare. ICD9-CM 820.xx (International Classification of Diseases, 9th Edition, Clinical Modification) codes identified hip fracture. Participants were censored at death or enrollment into managed Medicare. Static risk factors included sociodemographic, socioeconomic, place of residence, health behavior, disease history, and functional and cognitive status measures. A time-dependent marker reflecting postbaseline hospitalizations was included.

RESULTS: A total of 495 (8.9%) participants suffered a postbaseline hip fracture. In the static proportional hazards model, the greatest risks involved age (adjusted hazard ratios [AHRs] of 2.01, 2.82, and 4.91 for 75-79, 80-84, and > or =85 year age groups vs those aged 70-74 years; p values <.001), sex (AHR = 0.45 for men vs women; p < .001), race (AHRs of 0.37 and 0.46 for African Americans and Hispanics vs whites; p values <.001 and <.01), body mass (AHRs of 0.40, 0.77, and 1.73 for obese, overweight, and underweight vs normal weight; p values <.001, <.05, and <.01), smoking status (AHRs = 1.49 and 1.52 for current and former smokers vs nonsmokers; p values <.05 and <.001), and diabetes (AHR = 1.99; p < .001). The time-dependent recent hospitalization marker did not alter the static model effect estimates, but it did substantially increase the risk of hip fracture (AHR = 2.51; p < .001).

CONCLUSIONS: Enhanced discharge planning and home care for non-hip fracture hospitalizations could reduce subsequent hip fracture rates.

User Guide Notes

Endnote Keywords

Accidental Falls/Aged, 80 and over/Geriatric Assessment/Hip Fractures/Hospitalization/Prospective Studies/Risk Factors/Sex Distribution/Survival Analysis

Endnote ID


Alternate JournalJ Gerontol A Biol Sci Med Sci
Citation Key7405
PubMed ID19196641
PubMed Central IDPMC2655029
Grant ListU01 AG009740 / AG / NIA NIH HHS / United States
R01 AG 022913 / AG / NIA NIH HHS / United States