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Effectiveness of Hip Protectors to Reduce Risk for Hip Fracture from Falls in Long-Term Care
- Source :
- Journal of the American Medical Directors Association. 20:1397-1403.e1
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Objective To generate evidence of the effectiveness of hip protectors to minimize risk of hip fracture at the time of falling among residents of long-term care (LTC) by contrasting rates of hip fractures between falls with and without hip protectors. Design A 12-month, retrospective cohort study. We retrospectively reviewed fall incident reports recorded during the 12 months prior to baseline in participating homes. Setting and participants A population-based sample comprising all residents from 14 LTC homes owned and operated by a single regional health authority, who experienced at least 1 recorded fall during the 12-month study. Results At baseline, the pooled mean (standard deviation) age of residents in participating homes was 82.7 (11.3) years and 68% were female. Hip protectors were worn in 2108 of 3520 (60%) recorded falls. Propensity to wear hip protectors was associated with male sex, cognitive impairment, wandering behavior, cardiac dysrhythmia, use of a cane or walker, use of anti-anxiety medication, and presence of urinary and bowel incontinence. The incidence of hip fracture was 0.33 per 100 falls in falls with hip protectors compared with 0.92 per 100 falls in falls without hip protectors, representing an unadjusted relative risk (RR) of hip fracture of 0.36 (95% confidence interval 0.14–0.90, P = .029) between protected and unprotected falls. After adjusting for propensity to wear hip protectors, the RR of hip fracture was 0.38 (95% confidence interval 0.14–0.99, P = .048) during protected vs unprotected falls. Conclusions and implications Hip protectors were worn in 60% of falls, and the risk of hip fracture was reduced by nearly 3-fold by wearing a hip protector at the time of falling. Given that most clinical trials have failed to attain a similar level of adherence, our findings support the need for future research on the benefits of dissemination and implementation strategies to maximize adherence with hip protectors in LTC.
- Subjects :
- Male
musculoskeletal diseases
Orthotic Devices
medicine.medical_specialty
government.form_of_government
Population
03 medical and health sciences
0302 clinical medicine
Humans
Medicine
030212 general & internal medicine
education
General Nursing
Aged
Retrospective Studies
Aged, 80 and over
education.field_of_study
Hip fracture
Hip Fractures
business.industry
Protective Devices
Health Policy
Incidence (epidemiology)
Hip protector
Retrospective cohort study
General Medicine
medicine.disease
Long-Term Care
Confidence interval
Nursing Homes
3. Good health
Relative risk
embryonic structures
government
Physical therapy
Patient Compliance
Accidental Falls
Female
Geriatrics and Gerontology
business
030217 neurology & neurosurgery
Incident report
Subjects
Details
- ISSN :
- 15258610
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Journal of the American Medical Directors Association
- Accession number :
- edsair.doi.dedup.....da66049b60cce3a37d8dc72c58391b6a