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    National trends in extremity fracture hospitalizations among older adults between 2003 and 2017

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    Author
    Reider, Lisa
    Pollak, Andrew
    Wolff, Jennifer L
    Magaziner, Jay
    Levy, Joseph F
    Date
    2021-06-01
    Journal
    Journal of the American Geriatrics Society
    Publisher
    Blackwell Publishing
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1111/jgs.17281
    Abstract
    Background: Fractures in late life are highly consequential for health, services use, and spending. Little is known about trends in extremity fracture hospitalizations among older adults in the United States. Design: Retrospective longitudinal cohort study. Setting: The 2003–2017 National Inpatient Sample (NIS), a representative sample of U.S. community hospitals. Participants: Hospitalized adults aged 65 and older with a diagnosis of upper or lower extremity fracture. Measurements: Incidence of extremity fracture hospitalization and mortality, using NIS discharge and trend weights, and population denominators derived from the U.S. Census Bureau. Incidence was reported separately for men and women by age, fracture diagnosis, and injury mechanism. Weighted linear regression was used to test for significant trends over time. Results: Incidence of extremity fracture hospitalizations declined in both women (15.7%, p trend < 0.001) and men (3.2%, p trend < 0.001) between 2003 and 2017. This trend was primarily attributed to a decline in low energy femur fractures which accounted for 65% of all fracture hospitalizations. Among older adults with an extremity fracture hospitalization, mortality declined from 5.1% in 2003 to 3.3% in 2017 in men, and from 2.6% to 1.9% in women (p trend < 0.001). High energy fractures were due to falls (53%), motor vehicle accidents (34%), and other high impact injuries (13%). Overall, 12% of extremity fracture hospitalizations were attributed to high-energy injuries: increases were observed among men ages 65–74 (20%; p trend < 0.001) and 75–84 (10%; p trend = 0.013), but not among women of any age. Conclusion: Observed declines in the incidence of extremity fracture hospitalizations and related mortality are encouraging. However, increasing incidence of fracture hospitalization from high energy injuries among men suggests that older adults with complex injuries will be seen with more prevalence in the future. © 2021 The Authors.
    Rights/Terms
    © 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.
    Keyword
    extremity fractures
    falls
    high energy injuries
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16011
    ae974a485f413a2113503eed53cd6c53
    10.1111/jgs.17281
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