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Int. J. Environ. Res. Public Health 2018, 15(2), 289; https://doi.org/10.3390/ijerph15020289

Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents

1
Department of Health Services Research, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany
2
Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
3
Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
*
Author to whom correspondence should be addressed.
Received: 25 December 2017 / Revised: 1 February 2018 / Accepted: 4 February 2018 / Published: 7 February 2018
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
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Abstract

Little is known about hip fracture rates and post-fracture mortality among nursing home residents. This retrospective cohort study examined incidence rates (IR) of and mortality after hip fracture in this population focusing on sex differences. A cohort of >127,000 residents ≥65 years, newly admitted to German nursing homes between 2010 and 2014 were used to calculate age-, sex-, care-need- and time after admission-specific IR. To determine mortality, the Kaplan-Meier-method was applied. Using Cox regression, we studied mortality and estimated time-dependent hazard ratios (HRs). For this purpose, to each person with a hip fracture, one resident without a hip fracture was matched by sex, age and care-need using risk-set sampling. 75% were women (mean age: 84.0 years). During 168,588 person-years (PY), 8537 residents with at least one hip fracture were observed. The IR for women and men were 52.9 and 42.5/1000 PY. For both sexes, IR increased with rising age and decreased with increasing care-level. IR were highest in the first months after admission and subsequently declined afterwards. The impact of hip fractures on mortality was time-dependent. Mortality of residents with hip fracture was highest in the first two months after fracture compared to those without (HR): 2.82; 95% CI 2.57–3.11) and after six months, no differences were found (HR: 1.10; 95% CI 0.98–1.22) Further research should always include analyses stratified by sex, age and time period after admission. View Full-Text
Keywords: hip fracture; nursing home; incidence rate; mortality; health services research hip fracture; nursing home; incidence rate; mortality; health services research
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Jacobs, H.; Zeeb, H.; Hoffmann, F. Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents. Int. J. Environ. Res. Public Health 2018, 15, 289.

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