Risk factors for hip fracture in New Zealand older adults seeking home care services: a national population cross-sectional study.
Fracture risk
Hip fracture
New Zealand
Older people
interRAI
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
25 03 2019
25 03 2019
Historique:
received:
13
10
2018
accepted:
18
03
2019
entrez:
27
3
2019
pubmed:
27
3
2019
medline:
21
1
2020
Statut:
epublish
Résumé
Hip fractures are a common injury in older people. Many studies worldwide have identified various risk factors for hip fracture. However, risk factors for hip fracture have not been studied extensively in New Zealand. The interRAI home care assessment consists of 236 health questions and some of these may be related to hip fracture risk. The cohort consisted of 45,046 home care clients aged 65 years and older, in New Zealand. Assessments ranged from September 2012 to October 2015. Hip fracture diagnosis was identified by linking ICD (International Classification of Diseases) codes from hospital admissions data (September 2012 to December 2015) to the interRAI home care data. Unadjusted and adjusted competing risk regressions, using the Fine and Gray method were used to identify risk factors for hip fracture. Mortality was the competing event. The cohort consisted of 61% female with a mean age of 82.7 years. A total of 3010 (6.7%) of the cohort sustained a hip fracture after assessment. After adjusting for sociodemographic and potentially confounding variables falls (SHR (Subhazard Ratio) = 1.17, 95% CI (Confidence interval): 1.05-1.31), previous hip fracture (SHR = 4.16, 95% CI: 2.93-5.89), female gender (SHR = 1.38, 95% CI: 1.22-1.55), underweight (SHR = 1.67, 95% CI = 1.39-2.02), tobacco use (SHR = 1.56, 95% CI = 1.25-1.96), Parkinson's disease (SHR = 1.45, 95% CI: 1.14-1.84), and Wandering (SHR = 1.36, 95% CI: 1.07-1.72) were identified as risk factors for hip fracture. Shortness of breath (SHR = 0.80, 95% CI: 0.71-0.90), was identified as being protective against hip fracture risk. Males and females had different significant risk factors. Risk factors for hip fracture similar to international work on risk factors for hip fracture, can be identified using the New Zealand version of the interRAI home care assessment.
Sections du résumé
BACKGROUND
Hip fractures are a common injury in older people. Many studies worldwide have identified various risk factors for hip fracture. However, risk factors for hip fracture have not been studied extensively in New Zealand. The interRAI home care assessment consists of 236 health questions and some of these may be related to hip fracture risk.
METHODS
The cohort consisted of 45,046 home care clients aged 65 years and older, in New Zealand. Assessments ranged from September 2012 to October 2015. Hip fracture diagnosis was identified by linking ICD (International Classification of Diseases) codes from hospital admissions data (September 2012 to December 2015) to the interRAI home care data. Unadjusted and adjusted competing risk regressions, using the Fine and Gray method were used to identify risk factors for hip fracture. Mortality was the competing event.
RESULTS
The cohort consisted of 61% female with a mean age of 82.7 years. A total of 3010 (6.7%) of the cohort sustained a hip fracture after assessment. After adjusting for sociodemographic and potentially confounding variables falls (SHR (Subhazard Ratio) = 1.17, 95% CI (Confidence interval): 1.05-1.31), previous hip fracture (SHR = 4.16, 95% CI: 2.93-5.89), female gender (SHR = 1.38, 95% CI: 1.22-1.55), underweight (SHR = 1.67, 95% CI = 1.39-2.02), tobacco use (SHR = 1.56, 95% CI = 1.25-1.96), Parkinson's disease (SHR = 1.45, 95% CI: 1.14-1.84), and Wandering (SHR = 1.36, 95% CI: 1.07-1.72) were identified as risk factors for hip fracture. Shortness of breath (SHR = 0.80, 95% CI: 0.71-0.90), was identified as being protective against hip fracture risk. Males and females had different significant risk factors.
CONCLUSIONS
Risk factors for hip fracture similar to international work on risk factors for hip fracture, can be identified using the New Zealand version of the interRAI home care assessment.
Identifiants
pubmed: 30909862
doi: 10.1186/s12877-019-1107-1
pii: 10.1186/s12877-019-1107-1
pmc: PMC6434861
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
93Références
Bone. 1996 Jan;18(1 Suppl):77S-86S
pubmed: 8717551
Surgeon. 2010 Apr;8(2):111-6
pubmed: 20303894
Disabil Rehabil. 2014;36(8):685-90
pubmed: 23919643
Rev Endocr Metab Disord. 2010 Dec;11(4):229-36
pubmed: 19798582
Ann Intern Med. 2000 Jul 18;133(2):123-7
pubmed: 10896638
Arch Gerontol Geriatr. 2012 May-Jun;54(3):421-8
pubmed: 21862143
World J Orthop. 2016 Mar 18;7(3):171-81
pubmed: 27004165
BMC Musculoskelet Disord. 2005 Sep 05;6:47
pubmed: 16143046
Acta Clin Belg. 1993;48(3):190-4
pubmed: 8396300
N Z Med J. 1995 Sep 8;108(1007):367-8
pubmed: 7566776
J Gerontol. 1994 Jul;49(4):M174-82
pubmed: 8014392
J Bone Miner Res. 2011 Jun;26(6):1330-8
pubmed: 21611971
Osteoporos Int. 2005 Feb;16(2):155-62
pubmed: 15175845
J Am Geriatr Soc. 2010 Apr;58(4):783-7
pubmed: 20345862
J Bone Miner Res. 2005 Feb;20(2):185-94
pubmed: 15647811
J Aging Res. 2011 Apr 26;2011:741918
pubmed: 21584248
Aust N Z J Public Health. 2016 Aug;40(4):349-55
pubmed: 27197797
J Gerontol A Biol Sci Med Sci. 2019 Jun 18;74(7):1127-1133
pubmed: 30084928
Neurourol Urodyn. 2018 Apr;37(4):1336-1343
pubmed: 29130513
J Bone Miner Res. 2018 Dec;33(12):2150-2157
pubmed: 30011086
J Bone Joint Surg Am. 2014 Apr 16;96(8):674-81
pubmed: 24740664
PLoS Med. 2015 Oct 06;12(10):e1001885
pubmed: 26440803
J Bone Miner Res. 2012 Feb;27(2):294-300
pubmed: 22095911
J Bone Miner Res. 2009 May;24(5):768-74
pubmed: 19113932
Osteoporos Int. 2007 Aug;18(8):1109-17
pubmed: 17370100
BMJ. 2009 Nov 19;339:b4229
pubmed: 19926696
Osteoporos Int. 2005 Nov;16(11):1330-8
pubmed: 15928804
Osteoporos Int. 2007 Aug;18(8):1033-46
pubmed: 17323110
Br Med J (Clin Res Ed). 1986 Jun 14;292(6535):1547-8
pubmed: 3087511
J Bone Miner Res. 2012 Nov;27(11):2325-32
pubmed: 22692958
Osteoporos Int. 2008 Oct;19(10):1431-44
pubmed: 18324342
J Am Med Dir Assoc. 2017 Apr 1;18(4):368.e1-368.e8
pubmed: 28236610
J Bone Miner Res. 1999 Jan;14(1):129-35
pubmed: 9893075
J Gerontol A Biol Sci Med Sci. 2009 Mar;64(3):403-10
pubmed: 19196903
Osteoporos Int. 2005 Jun;16(6):581-9
pubmed: 15616758
J Gerontol A Biol Sci Med Sci. 2018 May 9;73(6):763-769
pubmed: 28958013
Int J Gen Med. 2010 Apr 08;3:1-17
pubmed: 20463818
J Gerontol A Biol Sci Med Sci. 2016 Sep;71(9):1230-4
pubmed: 26980299
J Orthop Trauma. 2012 Sep;26(9):e161-5
pubmed: 22377505
Nat Rev Endocrinol. 2014 Jun;10(6):338-51
pubmed: 24751883
BMC Health Serv Res. 2008 Dec 30;8:277
pubmed: 19115991
Osteoporos Int. 1997;7(4):344-7
pubmed: 9373568
J Neurol Sci. 2001 Jan 1;182(2):89-93
pubmed: 11137512
Stat Med. 2010 Feb 10;29(3):371-81
pubmed: 20014354