Clinical risk factors for hip fracture in elderly women: A case-control study

Objectives: To evaluate the strength of the association between clinical risk factors and hip fracture occurrence in elderly women. Design: A case-control study. Patients/Participants: Medical and social characteristics of 159 women with a first hip fracture (cases) were compared with 159 women without a hip fracture (controls) who were matched on age and residence. Methods: Using conditional logistic regression modeling, the odds ratio (OR) and the 95 percent confidence interval (95 percent CI) were estimated as measures of the relative hip fracture risk. Results: The highest hip fracture risk was associated with the self-perceived safety of the residence at the time of injury: if it were thought that the residence was not adequately equipped to allow safe motion or to perform the activities of daily living safely, this was associated with an almost sixfold increase in hip fracture risk (OR 5.8 95 percent CI 2.5 to 13.4). The hip fracture risk was also increased by a report of two or more other fractures before the first hip fracture (OR 2.6, 95 percent CI I. I to 6.3), any tendency to fall within one year of the injury date (OR 2.3, 95 percent Cl 1.8 to 4.1), and the chronic use of psychotropic drugs (OR 2.0, 95 percent CI 1.1 to 3.7). In contrast, ability to read a newspaper was protective against hip fracture (OR 0.3, 95 percent CI 0.2 to 0.7). Conclusions: This study suggests that these factors may be useful for an easy identification of women at high risk for hip fracture in the short term and, thus, who should benefit in priority from hip fracture prevention strategies.