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Prior non-hip limb fracture predicts subsequent hip fracture in institutionalized elderly people
Osteoporosis International, 09/29/09

Nakamura K et al. – A fracture history at upper or non-hip lower limbs, in combination with other known risk factors, is useful for the prediction of future hip fracture in institutional settings.

Methods

Cohort study with a 1-year follow-up
8,905 residents of nursing homes in Niigata, Japan (mean age, 84.3 years)
Fracture histories obtained from nursing home medical records
ADL levels assessed by caregivers
Hip fracture diagnosis based on hospital medical records

Results

Subjects had fracture histories of upper limbs (5.0%), hip (14.0%), and nonhip lower limbs (4.6%)
Prior nonhip lower limbs significantly predicted subsequent fracture (adjusted hazard ratio, 2.43; 95% confidence interval (CI), 1.30–4.57)
Stepwise method selected the best model, in which a combined historical fracture at upper limbs or nonhip lower limbs, dependence, ADL levels, mobility, dementia, weight, and type of nursing home independently predicted subsequent hip fracture