TITLE

Patients with femoral or distal forearm fracture in Germany: a prospective observational study on health care situation and outcome

AUTHOR(S)
Endres, Heinz G.; Dasch, Burkhard; Lungenhausen, Margitta; Maier, Christoph; Smektala, Rüdiger; Trampisch, Hans J.; Pientka, Ludger
PUB. DATE
January 2006
SOURCE
BMC Public Health;2006, Vol. 6, p87
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Distal radius and proximal femoral fractures are typical injuries in later life, predominantly due to simple falls, but modulated by other relevant factors such as osteoporosis. Fracture incidence rates rise with age. Because of the growing proportion of elderly people in Western industrialized societies, the number of these fractures can be expected to increase further in the coming years, and with it the burden on healthcare resources. Our study therefore assessed the effects of these injuries on the health status of older people over time. The purpose of this paper is to describe the study method, clinical parameters of fracture patients during hospitalization, mortality up to one and a half years after discharge in relation to various factors such as type of fracture, and to describe changes in mobility and living situation. Methods: Data were collected from all consecutive patients (no age limit) admitted to 423 hospitals throughout Germany with distal radius or femoral fractures (57% acute-care, femoral and forearm fractures; 43% rehabilitation, femoral fractures only) between January 2002 and September 2003. Polytrauma and coma patients were excluded. Demographic characteristics, exact fracture location, mobility and living situation, clinical and laboratory parameters were examined. Current health status was assessed in telephone interviews conducted on average 6-7 months after discharge. Where telephone contact could not be established, at least survival status (living/deceased/date of death) was determined. Results: The study population consisted of 12,520 femoral fracture patients (86.8% hip fractures), average age 77.5 years, 76.5% female, and 2,031 forearm fracture patients, average age 67.6 years, 81.6% female. Women's average age was 6.6 (femoral fracture) to 10 years (forearm fracture) older than men's (p < 0.0001). Only 4.6% of femoral fracture patients experienced changes in their living situation post-discharge (53% because of the fracture event), although less than half of subjects who were able to walk without assistive devices prior to the fracture event (76.7%) could still do so at time of interview (34.9%). At time of interview, 1.5% of subjects were bed-ridden (0.2% before fracture). Forearm fracture patients reported no change in living situation at all. Of the femoral fracture patients 119 (0.95%), and of the forearm fracture patients 3 (0.15%) died during hospital stay. Post-discharge (follow-up one and a half years) 1,463 femoral fracture patients died (19.2% acute-care patients, 8.5% rehabilitation patients), but only 60 forearm fracture patients (3.0%). Ninety percent of femoral fracture deaths happened within the first year, approximately 66% within the first 6 months. More acute-care patients with a pertrochanteric fracture died within one year post-discharge (20.6%) than patients with a cervical fracture (16.1%). Conclusion: Mortality after proximal femoral fracture is still alarmingly high and highest after pertrochanteric fracture. Although at time of interview more than half of femoral fracture patients reported reduced mobility, most patients (96%) attempt to live at home. Since forearm fracture patients were on average 10 years younger than femoral fracture patients, forearm fractures may be a means of diagnosing an increased risk of later hip fractures.
ACCESSION #
29362236

 

Related Articles

  • Don't miss underlying reason for elder's fall.  // ED Nursing;Mar2010, Vol. 13 Issue 5, p58 

    If your elderly patient reports a fall injury, carefully assess for fractures and identify what caused the fall. To improve care: • suspect loss of consciousness; • assess the ability to walk; • look for abrasions, bruising, or deformities.

  • Implementation of multifactorial interventions for fall and fracture prevention. Campbell, A. John; Robertson, M. Clare // Age & Ageing;Sep2006 Supplement 2, Vol. 35, pii60 

    Over 60% of falls experienced by older people result from multiple aetiological factors. Preventing falls in individual patients requires the identification and treatment of these interacting factors. Multifactorial interventions have been successful in some, but not all, fall prevention trials....

  • Repeat falls and the recovery of social participation in the year post-hip fracture. MILLER, RAM R.; BALLEW, SHOSHANA H.; SHARDELL, MICHELLE D.; HICKS, GREGORY E.; HAWKES, WILLIAM G.; RESNICK, BARBARA; MAGAZINER, JAY // Age & Ageing;Sep2009, Vol. 38 Issue 5, p570 

    Background: although the majority of hip fractures are the result of a fall, whether repeated falls in the year post-fracture adversely influence recovery of social participation is not known. Design: analysis of data from a longitudinal cohort study. Subjects: community-dwelling women aged...

  • Fracture rates in Parkinson's disease compared with age- and gender-matched controls: a retrospective cohort study. Genever, Richard W.; Downes, Thomas W.; Medcalf, Pippa // Age & Ageing;Jan2005, Vol. 34 Issue 1, p21 

    Introduction: patients with Parkinson's disease (PD) are not routinely prescribed bone-protecting medication despite the fact that they are known to be at risk of falling. We investigated whether subjects with PD were more at risk of fractures than other patient groups in order to establish...

  • PREDICTING FALLS IN OLDER WOMEN WITH VERTEBRAL FRACTURES: A PROSPECTIVE STUDY. Lobo, B.; Morris, R.; Harwood, R.; Sahota, O.; Masud, T. // Age & Ageing;May2004 Supplement 1, Vol. 33, pi9 

    Presents an abstract of the study "Predicting Falls in Older Women With Vertebral Fractures," by B. Lobo, R. Morris, R. Hardwood, O. Sahota and T. Masud.

  • HIP PROTECTOR. Filosa, Michael; Donhoffer, Hilda; Chan, Lillian // Wellness Options;2006, Issue 29, p27 

    The article looks at the use of external hip protectors to prevent fractures due to falls. Finnish researchers found that the risk of hip fracture can be significantly decreased if a hip protector is worn at the time of the fall. However, the researchers also found that many participants refused...

  • This geriatrician wears hip protectors. Sherman, Fredrick T. // Geriatrics;Aug2007, Vol. 62 Issue 8, p6 

    The article presents the author's experience of wearing two types of hip protectors as part of his plan to develop a new field of medicine which he called emphatetic medicine. He said that wearing these protectors over underpants made urinating more time consuming. He cited a study which aimed...

  • Risk of fracture with alendronic acid.  // Reactions Weekly;5/12/2007, Issue 1151, p3 

    The article reports on the 25 reports of fractures received by the Pharmacovigilance Unit of the Health Sciences Authority. The adverse events were observed in female patients who had received alendronic acid for one to ten years with a median age of 66.5 years. According to the article, minimal...

  • Hip Fracture Incidence from 1981 to 2009 in the Czech Republic as a Basis of the Country-Specific FRAX Model. Stepan, Jan; Vaculik, Jan; Pavelka, Karel; Zofka, Jan; Johansson, Helena; Kanis, John // Calcified Tissue International;May2012, Vol. 90 Issue 5, p365 

    The aim of this study was to calculate rates of hospitalization for hip fracture and the incidence of hip fractures in the Czech Republic over a period of 29 years. A second aim was to use the most recent data to populate a FRAX model for the assessment of fracture probability in individual...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics