Osteoporotic fracture increases risk for long-term institutionalization
MedWire News: Institutionalization rates are increased in patients who experience non-traumatic fracture, shows research.
"In the year following a hip fracture, up to 33% of patients become permanent nursing home residents," write Suzanne Morin (McGill University Health Center, Montreal, Quebec, Canada) and colleagues.
Osteoporotic fractures are known to adversely affect patients' subsequent quality of life, often contributing substantially to loss of independence in the elderly. Morin et al point out that although most research has focused on hip fractures, their most recent research, published in the journal Osteoporosis International, reports a similar effect on institutionalization risk after fracture at other osteoporosis-prone sites in the body.
The researchers identified 70,264 men and women aged 50 years or over from the community population of Manitoba, Canada, who sustained incident fractures between April 1, 1986, and March 31, 2006. Of these individuals, 17.3% had hip fracture and 36.0% had vertebrae, wrist, or humerus fracture, while the remainder involved other sites. Three controls were matched to each study participant according to gender and birth date.
The team found that 3996 of the fracture patients were admitted to long-term care institutions in the year following fracture. The age- and comorbidity- adjusted hazard ratio of institutionalization after hip fracture was 4.89 in men and 2.79 in women. Men had a significantly higher risk for transfer to long-term care than women after fracture at most sites. For both genders the relative risk for transfer was highest after hip or vertebral fracture, compared with other types of fracture.
Morin and team also found that rates of institutionalization increased steadily over the 2-decade study period. This can be explained, they say, by the increased prevalence of chronic disease among elderly patients and that the life expectancy of these patients rose over the course of the study.
"Osteoporosis-related fractures are extremely common and lead to serious consequences for affected patients and societies who must bear the rising cost of fracture treatment, subsequent disability, and in a sizable proportion, institutionalization," comment the researchers.
They conclude: "There is an urgent need to integrate structured, longer-term rehabilitation and co-morbidity management interventions in the community to lessen the functional disability associated with fractures that often leads to institutionalization."
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By Chloe McIvor