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Open AccessFeature PaperArticle

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

Department of Health Services Research, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany
Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(2), 289;
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)
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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