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Factors associated with hip fracture following a fall-associated hospitalization in older adults: a retrospective cohort study
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DOI：10.1007/s00198-026-08181-5.png)
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Abstract
En 中文
Among older adults hospitalized after a fall, receiving a DXA scan was associated with a decreased hazard of sustaining a hip fracture within 2 years. Older age, female sex, dementia, parkinsonism, mental health disorder and intermediate frailty were associated with a higher hazard of having a hip fracture post-discharge. Identify factors associated with increased hazard of having a hip fracture within 2 years of discharge following a fall-related hospitalization. We conducted a retrospective cohort study of all Ontario adults aged 65 + hospitalized after a fall between November 1, 2015 and October 31, 2020 using administrative health databases. We compared individuals who did or did not experience a hip fracture within 2 years of discharge based on socio-demographics, frailty, comorbidities, receipt of a dual-energy X-ray absorptiometry (DXA) scan, and family physician or geriatrician visits. We performed a Cox proportional hazard regression to identify factors associated with having a subsequent hip fracture, accounting for death as a competing risk. Among the 88,140 individuals who were discharged after a fall-related hospitalization, 4.6% suffered a hip fracture within 2 years. Older age (hazard ratio [HR] 1.04 per year, 95% confidence interval [CI] 1.04–1.05), female sex (HR 1.16, 95% CI 1.08–1.24), parkinsonism (HR 1.42, 95% CI 1.19–1.70), dementia (HR 1.28, 95% CI 1.17–1.41), mental health disorders (HR 1.10, 95% CI 1.01–1.20), and intermediate frailty risk by HFRS score (HR 6.68, 95% CI 3.28–13.7) were associated with a higher hazard of having a hip fracture. Post-discharge DXA scanning was associated with a decreased hip fracture hazard (HR 0.75, 95% CI 0.66–0.86), yet only 15% of the study population underwent this assessment. Timely fall risk reduction and bone health optimization efforts should focus on the high-risk groups identified in this study to help prevent hip fractures following fall-related hospitalizations.
Keywords:
Fall-associated hospitalization
Hip fracture
Retrospective cohort study
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