Femoral fracture rates after discharge from the hospital to the community

Abstract

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 person-years, respectively. We conclude that the first weeks at home after discharge from the hospital are associated with an increased risk for femoral fractures.