We all have heard the startling statistics about the impact a hip fracture has on elderly patients regarding their ability to remain independent. Even more dramatic is whether a patient will even survive this kind of an event at all. After reviewing 3981 hip fracture patients, Jiang et al (2005) found that in-hospital mortality for those patients studied was 6.3%, with men dying more frequently than women. For patients who were discharged from the hospital, almost one-third had died within 12 months of hospitalization for hip fracture.
Hawkes et al (2006) looked at the dif-ference between male and female hip fracture patients. Less than one-third of the patients in their hip fracture patient population were men. The interesting finding in this study revealed that the men in this study generally had more comorbidities and their mortality rate was twice as high as that for women in the study. At 2 years after hip fracture, 40% of the men had died compared to 20% of the female subjects. Those men and women who did survive had similar long-term functional abilities.
Hip fractures are often the final blow to tenuous living arrangements and independent life styles. Avoidance of hip fractures in all elderly patients should be something that we speak to frequently. Home and environmental assessments could provide essential information to patients and their families on ways to eliminate everyday dangers in the home setting. With that same concept, health-care facilities would serve all its patients by instituting hip fracture prevention protocols on all adult units in addition to ambulatory settings and surrounding environments. Have you ever walked through the parking garage at your hospital and spotted things that are an accident waiting to happen? Reporting risk situations should be a common activity for all of us on the healthcare team.
Finally, preventing hip fractures in elderly persons should be the goal of all healthcare providers. Early prevention of osteopenia and osteoporosis is a key element in decreasing hip fractures in our aging population. It is clear that the earlier we begin to educate our patients on the need to keep bones strong, the more hopeful the future will be for all of us. Describing to young adults the significant possible consequences of hip fracture in later years may be the necessary impetus for all of us to look at our own bone health.
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