Fractures after nursing home admission: incidence and potential consequences

Rapp, Kilian; Lamb, Sarah E; Klenk, Jochen; Kleiner, Andrea; Heinrich, Sven; König, Hans‐Helmut; Nikolaus, Th.; Becker, Clemens

doi:10.1007/s00198-009-0852-y

Cited by 36 publications

(29 citation statements)

References 28 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In community-living people without the need for care, excess risk was limited to the first month after discharge whereas the excess risk in people with the need for care declined gradually and resembled the risk pattern of residents newly admitted to a nursing home. (1,2) To our knowledge, there exists no data so far about fracture incidence as a function of time after discharge from hospital.…”

Section: Discussionmentioning

confidence: 99%

“…(1,2) In these studies the fracture risk after admission was highest during the first months and declined thereafter. For example, femoral fracture risk during the first month was nearly twice as high as the risk 9 months later.…”

Section: Introductionmentioning

confidence: 90%

“…Our a priori hypothesis was that a time-dependent risk pattern for femoral fractures after hospitalization can be observed in patients admitted from the community and discharged to the community and that this risk pattern is particularly pronounced in frail people and in people with nervous system diseases like dementia or Parkinson's disease. Therefore, we aimed: (1) to analyze the distribution of femoral fracture rates occurring at patients' homes as a function of time since discharge from hospital; (2) to perform the analyses separately in people with the need for care and without the need for care; and (3) to analyze if the pattern of risk was associated with specific discharge diagnostic groups.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Femoral fracture rates after discharge from the hospital to the community

Rapp

Cameron

Becker

et al. 2012

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Previous studies found that the risk of a femoral fracture in residents newly admitted to nursing homes was highest during the first months after admission and declined thereafter. Many nursing home admissions are preceded by a hospitalization. Therefore, the present study aimed to analyze if a similar risk pattern of fall-related fractures could also be observed in community-dwelling people at home after discharge from the hospital. Routine data of more than 690,000 German people aged 65 years and older with more than 2 million hospital discharges were used to calculate fracture rates in the first 6 months after hospitalization, for people discharged to live in the community. Incidence rates of femoral fractures as a function of time since discharge from hospital were analyzed. Analyses were stratified by sex, age, the need for care, and diagnostic groups. For femoral fractures the incidence was highest during the first months after discharge and declined thereafter. This pattern was observed in women and men, in different age-groups, in different diagnostic groups, and in people with and without the need for care. For example, rates for femoral fractures in women declined from 17.4 to 11.0 per 1000 person years over the first 6 months after admission, and in men over the same time period from 8.2 to 4.5 per 1000 personyears, respectively. We conclude that the first weeks at home after discharge from the hospital are associated with an increased risk for femoral fractures. ß

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Femoral fracture rates after discharge from the hospital to the community

Rapp

Cameron

Becker

et al. 2012

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

“…Since the risk of a hip fracture is highest during the first weeks after admission to the nursing home [13], hip protectors may be particularly useful for residents in this time period. Therefore, we suggest that residents are provided with hip protectors at no cost immediately after admission from a supply owned by each home.…”

Section: Discussionmentioning

confidence: 99%

Availability and use of hip protectors in residents of nursing homes

et al. 2010

Self Cite

View full text Add to dashboard Cite

show abstract

“…6,7 These patients differs from long-term care residents because they are in a new environment, are not well known by the staff, and their care is focused on increasing independence. 6,12 In the area of fall prevention, research has demonstrated that the initial transition to the nursing home is when short-stay patients are at greatest risk for falls and subsequent fractures. 12 It is estimated that 20% of short-stay patients fall in the first 30 days after nursing home admission and 4.7% of all short-stay patients will experience a hip fracture due to a fall in the nursing home.…”

Section: Introductionmentioning

confidence: 99%

What Happens to Patients When They Fracture Their Hip During a Skilled Nursing Facility Stay?

Leland

Gozalo

Bynum

et al. 2015

Journal of the American Medical Directors Association

View full text Add to dashboard Cite

Objectives To characterize outcomes of patients experiencing a fall and subsequent hip fracture while in a nursing home (NH) receiving skilled nursing facility (SNF) services. Design Observational study. Participants Short-stay fee-for-service Medicare beneficiaries who experienced their first hip fracture during a SNF stay. Measurements Outcomes measured in the 90 days after the hip fracture hospitalization included community discharge (with a stay in the community < 30 days), successful community discharge (in the community ≥30 days), death, and institutionalization. Results Between 1999 and 2007, 27,305 hip fractures occurred among short-stay nursing home patients receiving SNF care. After surgical repair of the hip fracture, 83.9% of these patients were discharged from the hospital back to a SNF, with most (99%) returning to the facility where the hip fracture occurred. In the first 90 days after hospitalization, 24.1% of patients died, 7.3% were discharged to the community but remained less than 30 days, 14.0% achieved successful community discharge, and 54.6% were still in a health care institution with almost 46.4% having transitioned to long-term care. Conclusion SNF care aims to maximize the short-stay patient’s independence and facilitate a safe community transition. However, experiencing a fall and hip fracture during the SNF stay was a sentinel event that limited the achievement of this goal. There is an urgent need to ensure the integration of fall prevention into the patient’s plan of care. Further, falls among SNF patients may serve as indicator of quality, which consumers and payers can use to make informed healthcare decisions.

show abstract

Fractures after nursing home admission: incidence and potential consequences

Abstract: Newly admitted residents have the highest fracture risk. The pattern of risk is similar across all fractures, suggesting a generic causal pathway. Implementation of effective fracture prevention efforts should be a priority at the time of admission to nursing homes.

Cited by 36 publications

References 28 publications

Femoral fracture rates after discharge from the hospital to the community

Femoral fracture rates after discharge from the hospital to the community

Availability and use of hip protectors in residents of nursing homes

What Happens to Patients When They Fracture Their Hip During a Skilled Nursing Facility Stay?

Contact Info

Product

Resources

About