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Prevalence, Characteristics, and Associated Risk Factors of the Elderly with Hip Fractures: A Cross-Sectional Analysis of NHANES 2005–2010

Authors Zhang YW, Lu PP, Li YJ, Dai GC, Chen MH, Zhao YK, Cao MM, Rui YF

Received 8 November 2020

Accepted for publication 22 December 2020

Published 27 January 2021 Volume 2021:16 Pages 177—185

DOI https://doi.org/10.2147/CIA.S291071

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Zhi-Ying Wu


Yuan-Wei Zhang,1– 5,* Pan-Pan Lu,1– 5,* Ying-Juan Li,2,6 Guang-Chun Dai,1– 5 Min-Hao Chen,1– 5 Ya-Kuan Zhao,1– 5 Mu-Min Cao,1– 5 Yun-Feng Rui1– 5

1Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People’s Republic of China; 2Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People’s Republic of China; 3School of Medicine, Southeast University, Nanjing, Jiangsu, People’s Republic of China; 4Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, People’s Republic of China; 5Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People’s Republic of China; 6Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yun-Feng Rui
Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu 210009, People’s Republic of China
Email ruiyunfeng@126.com

Objective: This cross-sectional study was aimed to update the assessment of prevalence, characteristics, and risk factors of the elderly with hip fractures in a non-institutionalized American population.
Methods: This current study included a total of 31,034 participants from the existing National Health and Nutritional Examination Survey (NHANES) database from 2005 to 2010, and 4,265 participants aged 65 years and older were ultimately identified. Their condition of hip fractures was determined by method of questionnaires according to the orthopedic surgeons’ diagnosis, and related epidemiological and demographic data were further collected. The univariate analysis was used to screen the risk factors of hip fractures in the elderly, and the logistic regression model was established to conduct the multivariate analysis.
Results: Of the total 4,265 participants with clear information of hip fractures in elderly, 127 individuals with hip fractures were identified according to results of questionnaires, exhibiting a prevalence of 28.49 per 1,000 (95% confidence interval [CI]=21.38– 35.60) for males and 31.03 per 1,000 (95% CI=23.72– 38.35) for females. The mean age of the elderly with hip fractures was 77.12± 5.88 years and tumble (48.0%) was the primary factor. In univariate analysis, age, race, smoking, drinking alcohol, and combined with osteoporosis were regarded as risk factors. Multivariate analysis showed that age (80 years and older), living alone, smoking, combined with diabetes and osteoporosis were the independent risk factors.
Conclusion: Our nationwide data indicate the prevalence of hip fractures in the elderly is generally on the rise, and the female occupies a higher proportion. Age (especially aged 80 years and older), race (mainly Non-Hispanic white), smoking, drinking alcohol, living alone, combined with diabetes and osteoporosis may be closely linked to the occurrence of hip fractures in the elderly, although these variables still need to be verified in further prospective investigations.

Keywords: hip fracture, the elderly, prevalence, risk factor, NHANES

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