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- Title
Death, Debility, and Destitution Following Hip Fracture.
- Authors
Tajeu, Gabriel S.; Delzell, Elizabeth; Smith, Wilson; Arora, Tarun; Curtis, Jeffrey R.; Saag, Kenneth G.; Morrisey, Michael A.; Yun, Huifeng; Kilgore, Meredith L.
- Abstract
Background. We examined the effects of hip fracture on mortality, entry into long-term institutional care, and new evidence of poverty. We estimate of the proportion of hip fracture patients who require not just short-term rehabilitation but who become dependent on long-term institutional care, and the risk of becoming newly dependent on Medicaid or eligible for low-income subsidies following hip fracture. Methods. We used data from 2005 through 2010 for a random 5% sample of Medicare beneficiaries (N = 3.1 million) to conduct a retrospective matched cohort study. We used high-dimensional propensity score matching to compare outcomes for patients who experienced a hip fracture with subjects who did not, but had similar propensity for suffering a hip fracture. We then compared the 1-year risk of death, debility, and destitution between groups. Results. We matched 43,210 hip fracture patients to comparators without a hip fracture. Hip fractures were associated with more than a twofold increase in likelihood of mortality (incidence proportion ratio [IPR] of 2.27, 95% CI, 2.20–2.34), a fourfold increase in likelihood of requiring long-term nursing facility care (IPR, 3.96; 95% CI, 3.77–4.16), and a twofold increase in the probability of entering into low-income status (IPR, 2.14; 95% CI 1.99–2.31) within 1 year following hip fracture compared with subjects without a hip fracture. Conclusions. Hip fracture in elderly patients resulted in increased death, debility, and destitution. Initiatives that lead to improved treatment of osteoporosis could result in a decrease in incidence of fractures, subsequent death, debility, and destitution for older adults.
- Subjects
HIP fractures; ASTHENIA; OSTEOPOROSIS; MEDICAID; RETROSPECTIVE studies; OLDER patients; ELDERLY poor; COHORT analysis
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2014, Vol 69A, Issue 3, p346
- ISSN
1079-5006
- Publication type
Article
- DOI
10.1093/gerona/glt105