Prevention of recurrent hip fracture.

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State: Public
Version: author
Serval ID
serval:BIB_6066396ED9A2
Type
Article: article from journal or magazin.
Collection
Publications
Title
Prevention of recurrent hip fracture.
Journal
Aging (Milano)
Author(s)
Staeger P., Burnand B., Santos-Eggimann B., Klay M., Siffert C., Livio J.J., Burckhardt P., Paccaud F.
ISSN
0394-9532
ISSN-L
0394-9532
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
12
Number
1
Pages
13-21
Language
english
Abstract
Our objective was to describe the interventions aimed at preventing a recurrent hip fracture, and other injurious falls, which were provided during hospitalization for a first hip fracture and during the two following years. A secondary objective was to study some potential determinants of these preventive interventions. The design of the study was an observational, two-year follow-up of patients hospitalized for a first hip fracture at the University Hospital of Lausanne, Switzerland. The participants were 163 patients (median age 82 years, 83% women) hospitalized in 1991 for a first hip fracture, among 263 consecutively admitted patients (84 did not meet inclusion criteria, e.g., age>50, no cancer, no high energy trauma, and 16 refused to participate). Preventive interventions included: medical investigations performed during the first hospitalization and aimed at revealing modifiable pathologies that raise the risk of injurious falls; use of medications acting on the risk of falls and fractures; preventive recommendations given by medical staff; suppression of environmental hazards; and use of home assistance services. The information was obtained from a baseline questionnaire, the medical record filled during the index hospitalization, and an interview conducted 2 years after the fracture. Potential predictors of the use of preventive interventions were: age; gender; destination after discharge from hospital; comorbidity; cognitive functioning; and activities of daily living. Bi- and multivariate associations between the preventive interventions and the potential predictors were measured. In hospital investigations to rule out medical pathologies raising the risk of fracture were performed in only 20 patients (12%). Drugs raising the risk of falls were reduced in only 17 patients (16%). Preventive procedures not requiring active collaboration by the patient (e.g., modifications of the environment) were applied in 68 patients (42%), and home assistance was provided to 67 patients (85% of the patients living at home). Bivariate analyses indicated that prevention was less often provided to patients in poor general conditions, but no ascertainment of this association was found in multivariate analyses. In conclusion, this study indicates that, in the study setting, measures aimed at preventing recurrent falls and injuries were rarely provided to patients hospitalized for a first hip fracture at the time of the study. Tertiary prevention could be improved if a comprehensive geriatric assessment were systematically provided to the elderly patient hospitalized for a first hip fracture, and passive preventive measures implemented.
Keywords
Aged, Aged, 80 and over, Antihypertensive Agents, Calcium, Counseling, Drug Combinations, Estrogen Replacement Therapy, Female, Hip Fractures, Home Care Services, Humans, Male, Middle Aged, Psychotropic Drugs, Recurrence, Vitamin D
Pubmed
Web of science
Create date
14/02/2008 16:13
Last modification date
20/08/2019 15:17
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