TY - JOUR T1 - Recent hospitalization and the risk of hip fracture among older Americans. JF - J Gerontol A Biol Sci Med Sci Y1 - 2009 A1 - Frederic D Wolinsky A1 - Suzanne E Bentler A1 - Li Liu A1 - Maksym Obrizan A1 - Elizabeth A Cook A1 - Kara B Wright A1 - John F Geweke A1 - Elizabeth A Chrischilles A1 - Claire E Pavlik A1 - Robert L. Ohsfeldt A1 - Michael P Jones A1 - Kelly K Richardson A1 - Gary E Rosenthal A1 - Robert B Wallace KW - Accidental Falls KW - Age Distribution KW - Aged KW - Aged, 80 and over KW - Aging KW - Cohort Studies KW - Female KW - Follow-Up Studies KW - Geriatric Assessment KW - Hip Fractures KW - Hospitalization KW - Humans KW - Logistic Models KW - Male KW - Multivariate Analysis KW - Probability KW - Proportional Hazards Models KW - Prospective Studies KW - Risk Factors KW - Sex Distribution KW - Survival Analysis KW - United States AB -

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.

PB - 64 VL - 64 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/19196641?dopt=Abstract U2 - PMC2655029 U4 - Accidental Falls/Aged, 80 and over/Geriatric Assessment/Hip Fractures/Hospitalization/Prospective Studies/Risk Factors/Sex Distribution/Survival Analysis ER -