Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Study Population
2.2. Hip Fractures
2.3. Selection of Controls
2.4. Statistical Analyses
3. Results
3.1. Baseline Characteristics
3.2. Incidence of Hip Fracture
3.3. Mortality after Hip Fracture Compared to Controls
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Appendix A
Women | Men | Total | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
N† | PY | IR ☐ (95% CI) | N† | PY | IR ☐ (95% CI) | N† | PY | IR ☐ (95% CI) | ||
Months after admission | ||||||||||
1 | 732 | 7345 | 99.7 (92.6–107.1) | 190 | 2439 | 77.9 (67.2–89.8) | 922 | 9784 | 94.2 (88.2–100.5) | |
2 | 509 | 6652 | 76.5 (70.0–83.5) | 123 | 2137 | 57.6 (47.8–68.7) | 632 | 8789 | 71.9 (66.4–77.7) | |
3 | 403 | 6194 | 65.1 (58.9–71.7) | 98 | 1947 | 50.3 (40.9–61.3) | 501 | 8140 | 61.5 (56.3–67.2) | |
4 | 398 | 5842 | 68.1 (61.6–75.2) | 82 | 1803 | 45.5 (36.2–56.5) | 480 | 7645 | 62.8 (57.3–68.7) | |
5 | 348 | 5546 | 62.7 (56.3–69.7) | 66 | 1681 | 39.3 (30.4–50.0) | 414 | 7227 | 57.3 (51.9–63.1) | |
6 | 301 | 5286 | 56.9 (50.7–63.8) | 63 | 1578 | 39.9 (30.7–51.1) | 364 | 6864 | 53.0 (47.7–58.8) | |
7 | 291 | 5059 | 57.5 (51.1–64.5) | 65 | 1488 | 43.7 (33.7–55.7) | 356 | 6546 | 54.4 (48.9–60.3) | |
8 | 248 | 4837 | 51.3 (45.1–58.1) | 55 | 1406 | 39.1 (29.5–50.9) | 303 | 6244 | 48.5 (43.2–54.3) | |
9 | 254 | 4632 | 54.8 (48.3–62.0) | 59 | 1331 | 44.3 (33.8–57.2) | 313 | 5963 | 52.5 (46.8–58.6) | |
10 | 196 | 4433 | 44.2 (38.2–50.9) | 52 | 1260 | 41.3 (30.8–54.1) | 248 | 5693 | 43.6 (38.3–49.3) | |
11 | 178 | 4245 | 41.9 (36.0–48.6) | 40 | 1195 | 33.5 (23.9–45.6) | 218 | 5440 | 40.1 (34.9–45.8) | |
12 | 185 | 4054 | 45.6 (39.3–52.7) | 55 | 1134 | 48.5 (36.5–63.1) | 240 | 5189 | 46.3 (40.6–52.5) |
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Men | Women | IRR Women/Men (95% CI) | |||||
---|---|---|---|---|---|---|---|
N † | PY | IR ☐ (95% CI) | N † | PY | IR ☐ (95% CI) | ||
Age (years) | |||||||
65–69 | 54 | 2440 | 22.1 (16.6–28.9) | 128 | 4074 | 31.4 (26.2–37.4) | 1.42 (1.04–1.96) |
70–74 | 116 | 4627 | 25.1 (20.7–30.1) | 332 | 10,158 | 32.7 (29.3–36.4) | 1.30 (1.06–1.62) |
75–79 | 188 | 6222 | 30.2 (26.0–34.9) | 698 | 16,949 | 41.2 (38.2–44.4) | 1.36 (1.16–1.60) |
80–84 | 364 | 8568 | 42.5 (38.2–47.1) | 1448 | 28,733 | 50.4 (47.8–53.1) | 1.19 (1.06–1.33) |
85–89 | 470 | 8887 | 52.9 (48.2–57.9) | 2497 | 42,418 | 58.9 (56.6–61.2) | 1.11 (1.01–1.23) |
90–94 | 282 | 4493 | 62.8 (55.7–70.5) | 1555 | 24,518 | 63.4 (60.3–66.7) | 1.01 (0.89–1.15) |
≥95 | 64 | 962 | 66.6 (51.3–85.0) | 341 | 5540 | 61.5 (55.2–68.4) | 0.92 (0.71–1.21) |
Level of care | |||||||
0/I | 948 | 21,060 | 45.0 (42.2–48.0) | 4937 | 89,880 | 54.9 (53.4–56.5) | 1.22 (1.14–1.31) |
II | 538 | 12,852 | 41.9 (38.4–45.6) | 1909 | 37,214 | 51.3 (49.0–53.7) | 1.22 (1.11–1.35) |
III | 52 | 2286 | 22.7 (17.0–29.8) | 153 | 5296 | 28.9 (24.5–33.8) | 1.27 (0.93–1.75) |
Total | 1538 | 36,198 | 42.5 (40.4–44.7) | 6999 | 132,390 | 52.9 (51.6–54.1) | 1.24 (1.18–1.32) |
Women | Men | Total | ||||
---|---|---|---|---|---|---|
Cases | Controls | Cases | Controls | Cases | Controls | |
Mortality in % (95% CI) | ||||||
0.5 year | 27.6 | 14.3 | 44.3 | 21.3 | 30.6 | 15.6 |
(26.6–28.7) | (13.5–15.2) | (41.7–46.8) | (19.9–23.6) | (29.6–31.7) | (14.8–16.4) | |
1 year | 36.7 | 24.1 | 54.3 | 35.4 | 39.9 | 26.1 |
(35.5–38.0) | (23.0–25.2) | (51.7–57.0) | (32.9–38.1) | (38.8–41.1) | (25.1–27.1) | |
2 years | 51.2 | 40.6 | 67.4 | 57.1 | 54.1 | 43.5 |
(49.8–52.6) | (39.2–42.0) | (64.6–70.2) | (54.0–60.3) | (52.8–55.4) | (42.2–44.8) | |
3 years | 63.1 | 54.4 | 78.1 | 70.8 | 65.8 | 57.2 |
(61.5–64.8) | (52.6–56.1) | (74.9–81.2) | (67.2–74.4) | (64.3–67.3) | (55.6–58.8) | |
4 years | 71.7 | 65.1 | 88.2 | 78.3 | 74.6 | 67.4 |
(69.6–73.9) | (62.7–67.7) | (83.7–91.9) | (73.8–82.6) | (72.7–76.5) | (65.3–69.6) |
Women (HR (95% CI)) | Men (HR (95% CI)) | Combined (HR (95% CI)) | |
---|---|---|---|
Cases vs. Controls | |||
x 1–2 months | 2.65 (2.37–2.99) | 3.34 (2.78–4.01) | 2.82 (2.57–3.11) |
x 3–4 months | 1.92 (1.65–2.23) | 2.07 (1.58–2.72) | 1.96 (1.72–2.23) |
x 5–6 months | 1.48 (1.24–1.76) | 1.35 (0.96–1.92) | 1.46 (1.25–1.70) |
x 7–12 months | 1.11 (0.98–1.26) | 1.05 (0.83–1.33) | 1.10 (0.98–1.22) |
x >12 months | 1.05 (0.96–1.14) | 0.94 (0.78–1.13) | 1.03 (0.95–1.11) |
Sex (men vs. women) | - | - | 1.72 (1.62–1.81) |
Age | |||
65–74 years | 1 | 1 | 1 |
75–84 years | 1.34 (1.17–1.53) | 1.50 (1.24–1.82) | 1.40 (1.25–1.56) |
85–94 years | 1.89 (1.66–2.15) | 2.06 (1.71–2.47) | 1.95 (1.76–2.17) |
≥95 years | 2.70 (2.30–3.16) | 3.08 (2.36–4.04) | 2.82 (2.47–3.23) |
Level of care | |||
0/I | 1 | 1 | 1 |
II | 1.23 (1.17–1.30) | 1.22 (1.11–1.35) | 1.12 (1.17–1.29) |
III | 1.74 (1.50–2.03) | 1.31 (1.02–1.69) | 1.60 (1.40–1.82) |
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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. https://doi.org/10.3390/ijerph15020289
Jacobs H, Zeeb H, Hoffmann F. Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents. International Journal of Environmental Research and Public Health. 2018; 15(2):289. https://doi.org/10.3390/ijerph15020289
Chicago/Turabian StyleJacobs, Hannes, Hajo Zeeb, and Falk Hoffmann. 2018. "Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents" International Journal of Environmental Research and Public Health 15, no. 2: 289. https://doi.org/10.3390/ijerph15020289