The Harstad injury prevention study: the characteristics and distribution of fractures amongst elders--an eight year study

Abstract

Study objective: To do a complete survey of hospital-treated fractures in the aged (65+ years old) and to report the characteristics and distribution of all fractures occurring within this defined population.

Design: Prospective injury recording study.

Setting: The Norwegian municipality of Harstad (population 23,000) during eight years from 1 July 1985.

Participants: The person years of the study estimated from yearly census data, were 22,970.

Measurements and main results: The variables were selected and coded according to the Nordic system and the data were collected as part of a national injury surveillance system. Of 753 recorded fractures, nine out of ten were caused by falls. 50.6% of fractures occurred in private homes, 24.4% in traffic areas (traffic accidents excluded), 13.3% in nursing homes. Adjusting for exposure, fracture rates (per 1000 person years) were 70.0 in nursing homes, 17.7 in private homes, and 8.5 in traffic areas in winter (traffic accidents excluded). The fracture risk in traffic areas increased fivefold in months with snow.

Conclusion: Nine out of ten fractures in the aged were caused by falls. Although the fracture risk for the elderly living in a nursing home was four times as high as those living in private homes, the volume of fractures occurring in private homes and traffic areas make them a prime target for interventions. Continuous prospective hospital recording of fractures in a community of aged is feasible and provides a tool for targeting interventions and evaluating the outcome of a community fall-fracture prevention programme.