Berry Sarah D, Lee Yoojin, Zullo Andrew R, Kiel Doug P, Dosa David, Mor Vincent
Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Department of Health Services, Policy, and Practice & Center for Gerontology, Brown University School of Public Health, Providence, Rhode Island.
J Gerontol A Biol Sci Med Sci. 2016 Sep;71(9):1230-4. doi: 10.1093/gerona/glw034. Epub 2016 Mar 14.
Hip fractures are associated with significant morbidity and mortality in the nursing home. Our objective was to describe the incidence rate (IR) of hip fracture according to age, sex, and race in a nationwide sample of long-stay nursing home residents.
Using 2007-2010 Medicare claims data linked with the Minimum Data Set, we identified 892,837 long-stay residents (≥100 days in the same nursing facility) between May 1, 2007 and April 30, 2008. Hip fractures were defined using Part A diagnostic codes (ICD-9). Residents were followed from the date they became a long-stay resident until the first event of death, discharge, hip fracture, or 2 years of follow-up.
Mean age was 84 years (range 65-113 years), and 74.5% were women. 83.9% were white and 12.0% were black. The overall IR of hip fracture was 2.3/100 person years. The IR was similar in men and women across age groups. The IR of hip fracture was highest in Native Americans aged 85 years or older (3.7/100 person years), in whites (2.6/100 person years), and during the first 100 days of institutionalization (2.7/100 person years). IRs of hip fracture were lowest in blacks (1.3/100 person years).
In nursing home residents surviving 100 days or more in a facility, the incidence of hip fracture is high, particularly among older white, Native American, and newly admitted residents. This is the first nationwide study to provide sex- and age-specific estimates among U.S. nursing home residents, and it underscores the magnitude of the problem.
髋部骨折与疗养院中的高发病率和死亡率相关。我们的目标是在全国范围内的长期居住疗养院居民样本中，描述根据年龄、性别和种族划分的髋部骨折发病率（IR）。
利用2007 - 2010年医疗保险索赔数据与最低数据集相链接，我们确定了2007年5月1日至2008年4月30日期间的892,837名长期居住居民（在同一疗养院居住≥100天）。髋部骨折使用A部分诊断代码（ICD - 9）进行定义。从居民成为长期居住居民之日起对其进行随访，直至首次出现死亡、出院、髋部骨折事件或随访2年。
平均年龄为84岁（范围65 - 113岁），74.5%为女性。83.9%为白人，12.0%为黑人。髋部骨折的总体发病率为2.3/100人年。各年龄组中男性和女性的发病率相似。85岁及以上的美国原住民髋部骨折发病率最高（3.7/100人年），白人中发病率为（2.6/100人年），在入住机构的前100天发病率为（2.7/100人年）。黑人的髋部骨折发病率最低（1.3/100人年）。
在疗养院中存活100天或更长时间的居民中，髋部骨折的发病率很高，尤其是在老年白人、美国原住民和新入院居民中。这是第一项在全国范围内针对美国疗养院居民提供按性别和年龄划分估计值的研究，它凸显了该问题的严重性。
