ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026
Factors associated with hip fracture following a fall-associated hospitalization in older adults: a retrospective cohort study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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. PURPOSE: Identify factors associated with increased hazard of having a hip fracture within 2 years of discharge following a fall-related hospitalization.
methodsWe 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.
resultsAmong 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.
conclusionTimely 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.
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