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Open Access Research article

Hip fracture in hospitalized medical patients

Antonio Zapatero1, Raquel Barba2*, Jesús Canora1, Juan E Losa3, Susana Plaza4, Jesús San Roman5 and Javier Marco6

Author Affiliations

1 Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain

2 Servicio de Medicina Interna, Hospital Rey Juan Carlos, Móstoles, Madrid, Spain

3 Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain

4 Servicio de Medicina Interna, Hospital Severo Ochoa, Leganes, Madrid, Spain

5 Departamento de Medicina y Cirugía, Universidad Rey Juan Carlos, Madrid, Spain

6 Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, Spain

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BMC Musculoskeletal Disorders 2013, 14:15  doi:10.1186/1471-2474-14-15

Published: 8 January 2013

Abstract

Background

The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain.

Methods

We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization.

Outcome measures included rates of in-hospital fractures, length of stay and cost.

Results

A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p < 0.001, and the mean length of stay was significantly longer for patients with a hip fracture (20.7 days vs 9.8 days; p < 0.001). Cost were higher in hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49).

Conclusions

In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

Keywords:
Hip-fracture; Hospitalized; Internal medicine; Morbidity; Mortality; Security