Fisher E S, Baron J A, Malenka D J, Barrett J A, Kniffin W D, Whaley F S, Bubolz T A
Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH 03756.
Epidemiology. 1991 Mar;2(2):116-22. doi: 10.1097/00001648-199103000-00005.
We used Medicare data to conduct a population-based study of osteoporotic hip fracture incidence and outcomes among New England residents. To reduce bias and improve data reliability, we combined data from multiple files; we found that 6% of cases would have been missed had we relied on hospital claims alone. Hip fracture incidence (per 1,000 person-years) increased for white females from 2.2 for ages 65-69 to 31.8 for ages 90-94 and for white males from 0.9 for ages 65-69 to 20.8 for ages 90-94. Incidence among blacks was lower in all age/sex groups. The female/male relative risk was greater among whites than among blacks. Case fatality following hip fracture was 12.5% at 90 days and 23.7% at 1 year and was higher among males, older patients, and those who had documented comorbidity or who were residents of nursing homes.