American Journal of Epidemiology Vol. 140, No. 9: 830-838
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Risk Factors for Hip Fractures Occurring in the Hospital
1The Geriatrics Research, Education, and Clinical Center, Audie L. Murphy Memorial VA Hospital San Antonio, TX
2Division of Geriatrics and Gerontology, University of Texas Health Science Center at San Antonio San Antonio, TX
3Division of Pharmacoepidemiology, Department Preventive Medicine, Vanderbilt University School of Medicine Nashville, TN
4Laboratory and Disease Control Services Regina, Saskatchewan, Canada
Reprint requests to Dr. Wayne A. Ray, Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2637
Risk factors for in-hospital hip fractures among patients aged 
65 years were evaluated in a population-based case-control study conducted in the Canadian province of Saskatchewan from 1983 through 1985. There were 129 cases with confirmed in-hospital hip fractures and 234 controls, who were those controls from a previous study in this setting hospitalized on their assigned index date. Study variables were abstracted from the hospital chart. Six factors were independently associated with a significantly increased risk of in-hospital hip fracture: impaired vision (odds ratio = 1.97, 95% confidence interval (Cl) 1.18–3.30), assisted ambulation (odds ratio = 2.12, 95% Cl 1.25–3.59), confusion (odds ratio = 2.48, 95% Cl 1.37–4.48), psychotropic drug use (odds ratio = 2.02, 95% Cl 1.22–3.33), lowest weight tertile (odds ratio = 2.86, 95% Cl 1.38–5.92), and prior in-hospital fall (odds ratio = 2.71, 95% Cl 1.52– 4.82). The risk increased substantially with the number of factors present, from an odds ratio of 4.08 (95% Cl 1.56–10.67) for one factor (reference group, no factors) to 82.84 (95% Cl 18.6–368.7) for four or more factors (
<0.001, test for trend). These data underscore the multifactorial etiology of in-hospital hip fracture and suggest that prevention programs need to target multiple risk factors. Am J Epidemiol 1994;140:830–8.
accidental falls; aged; hip fractures; hospitals; psychotropic drugs; wounds and injuries
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