The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study

• Published in: American journal of public health (1971) Vol. 87; no. 3; pp. 398 - 403
• Main Authors: Wolinsky, F D, Fitzgerald, J F, Stump, T E
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01-03-1997; American Public Health Association
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Aging; Alzheimer's disease; Biological and medical sciences; Cardiovascular disease; Causality; Chronic Disease; Diseases of the osteoarticular system; Elderly people; Factors; Female; Fractured hips; Fractures; Frail Elderly - statistics & numerical data; Functional status; Health; Health care policy; Health services; Health services utilization; Hip Fractures - mortality; Hip joint; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Humans; Linear Models; Longitudinal studies; Male; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Mortality; Multivariate Analysis; Nursing homes; Older people; Outcome Assessment (Health Care); Polls & surveys; Prospective Studies; Public health; Random variables; Regression analysis; Standard deviation; United States - epidemiology; USA; United States; North America; America; Hip joint; Human; Mortality; Diseases of the osteoarticular system; Risk; Fracture; Hospitalization; Trauma; Epidemiology; Follow up study; Functional dependence; Complication; Bone; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.87.3.398

The purpose of this study was to prospectively assess the independent effect of hip fracture on mortalìty, hospitalization, and functional status.
Among 7527 members of the Longitudinal Study of Aging who were over age 70 at baseline, 368 persons with hip fracture occurring between 1984 and 1991 were identified. Median length of follow-up was 831 days.
Hip fracture was significantly related to mortality (adjusted hazards ratio [AHR] = 1.83; 95% confidence interval [CI] = 1.55, 2.16) when treated as a time-dependent covariate. This effect was concentrated in the first 6 months postfracture (AHR = 38.93, 95% CI = 29.58, 51.23, vs AHR = 1.17; 95% CI = 0.95, 1.44). Hip fracture significantly increased the likelihood of subsequent hospitalization (adjusted odds ratio = 3.31, 95% CI = 2.64, 4.15) and increased the number of subsequent episodes by 9.4%, the number of hospital days by 21.3%, and total charges by 16.3%. Hip fracture also increased the number of functional status dependencies.
The health of older adults deteriorates after hip fracture, and efforts to reduce the incidence of hip fracture could lower subsequent mortality, morbidity, and health services use.