High efficacy for hip protectors in the prevention of hip fractures among elderly people with dementia

Objective: To evaluate the efficacy of hip protectors (HP) in preventing hip fractures (NF) in patients with dementia. Design: A case-control study. Setting: Four specialized dementia units. Participants: 206 physically independent patients with dementia. Interventions: Beginning in January 2004, following the recommendation of the Israeli Ministry of Health, we recommended the use of HP (Hip Saver-nursing home type) to each family/guardian of all patients in these departments. Measurements: The rate of falls and HF per falls in patients with and without HP. Results: We achieved patient compliance of 70% to 80% for wearing the HP 24 hours a day; 106 patients were permanently wearing HP for a total period of 1905 months. Of those, subgroup B of 63 patients had been monitored prior to January 2004, before HP were introduced. One hundred patients of the same departments have never used HP; together with the months of follow-up before January 2004 in subgroup B, the follow-up period in patients not wearing HP, reached a total of 3136 months. There was no statistical difference between patients with/without HP regarding age, gender, comorbidities, routine laboratory findings, and medications. The rate of falls was not significantly different in patients with and without HP. However, there was a significant difference in the rate of hip fractures (HF): in patients not wearing HP there were 323 falls resulting in 14 HF, and in patients wearing HP, 260 falls but only 2 HF (4.3% versus 0.8%, respectively, P =.007, chi-square test, 95% confidence interval 1.3-24.6, NNT = 28). Conclusions: When appropriately introduced and used, hip protectors have high efficacy in preventing hip fractures in long-term care patients with dementia. The medical, social, and economic beneficial outcomes are substantial.