Skip to main content
Top
Published in: Osteoporosis International 9/2009

01-09-2009 | Original Article

Spatial temporal modeling of hospitalizations for fall-related hip fractures in older people

Authors: R. M. Turner, A. Hayen, W. T. M. Dunsmuir, C. F. Finch

Published in: Osteoporosis International | Issue 9/2009

Login to get access

Abstract

Summary

The study determined the spatial temporal characteristics of fall-related hip fractures in the elderly using routinely collected injury hospitalization and sociodemographic data. There was significant spatial temporal variation in hospitalized hip fracture rates in New South Wales, Australia.

Introduction

The study determined the spatial temporal characteristics of fall-related hip fractures in the elderly using routinely collected injury hospitalization data.

Methods

All New South Wales (NSW), Australia residents aged 65+ years who were hospitalized for a fall-related hip fracture between 1 July 1998 and 30 June 2004 were included. Bayesian Poisson regression was used to model rates in local government areas (LGAs), allowing for the incorporation of spatial, temporal, and covariate effects.

Results

Hip fracture rates were significantly decreasing in one LGA, and there were no significant increases in any LGAs. The proportion of the population in residential aged care facilities was significantly associated with the rate of hospitalized hip fractures with a relative risk (RR) of 1.003 (95% credible interval 1.002, 1.004). Socioeconomic status was also related to hospitalized hip fractures with those in the third and fourth quintiles being at decreased risk of hip fracture compared to those in the least disadvantaged (fifth) quintile [RR = 0.837 (0.717, 0.972) and RR = 0.855 (0.743, 0.989) respectively].

Conclusions

There was significant spatial temporal variation in hospitalized hip fracture rates in NSW, Australia. The use of Bayesian methods was crucial to allow for spatial correlation, covariate effects, and LGA boundary changes.
Appendix
Available only for authorised users
Literature
1.
go back to reference Boufous S, Finch CF, Lord SR (2004) Incidence of hip fracture in New South Wales: are our efforts having an effect. Med J Aust 180:623–626PubMed Boufous S, Finch CF, Lord SR (2004) Incidence of hip fracture in New South Wales: are our efforts having an effect. Med J Aust 180:623–626PubMed
2.
go back to reference Marks R, Allegrante JP, Ronald MacKenzie C et al (2003) Hip fractures among the elderly: causes, consequences and control. Ageing Res Rev 2:57–93PubMedCrossRef Marks R, Allegrante JP, Ronald MacKenzie C et al (2003) Hip fractures among the elderly: causes, consequences and control. Ageing Res Rev 2:57–93PubMedCrossRef
3.
go back to reference Kannus P, Niemi S, Parkkari J et al (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805PubMedCrossRef Kannus P, Niemi S, Parkkari J et al (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805PubMedCrossRef
4.
go back to reference Balasegaram S, Majeed A, Fitz-Clarence H (2001) Trends in hospital admissions for fractures of the hip and femur in England, 1989–1990 to 1997–1998. J Public Health Med 23:11–17PubMedCrossRef Balasegaram S, Majeed A, Fitz-Clarence H (2001) Trends in hospital admissions for fractures of the hip and femur in England, 1989–1990 to 1997–1998. J Public Health Med 23:11–17PubMedCrossRef
5.
go back to reference Rowe SM, Song EK, Kim JS et al (2005) Rising incidence of hip fracture in Gwangju City and Chonnam Province, Korea. J Korean Med Sci 20:655–658PubMedCrossRef Rowe SM, Song EK, Kim JS et al (2005) Rising incidence of hip fracture in Gwangju City and Chonnam Province, Korea. J Korean Med Sci 20:655–658PubMedCrossRef
6.
go back to reference Yiannakoulias N, Rowe BH, Svenson LW et al (2003) Zones of prevention: the geography of fall injuries in the elderly. Soc Sci Med 57:2065–2073PubMedCrossRef Yiannakoulias N, Rowe BH, Svenson LW et al (2003) Zones of prevention: the geography of fall injuries in the elderly. Soc Sci Med 57:2065–2073PubMedCrossRef
7.
go back to reference Farahmand BY, Persson PG, Michaelsson K et al (2000) Socioeconomic status, marital status and hip fracture risk: a population-based case–control study. Osteoporos Int 11:803–808PubMedCrossRef Farahmand BY, Persson PG, Michaelsson K et al (2000) Socioeconomic status, marital status and hip fracture risk: a population-based case–control study. Osteoporos Int 11:803–808PubMedCrossRef
8.
go back to reference West J, Hippisley-Cox J, Coupland CA et al (2004) Do rates of hospital admission for falls and hip fracture in elderly people vary by socio-economic status. Public Health 118:576–581PubMedCrossRef West J, Hippisley-Cox J, Coupland CA et al (2004) Do rates of hospital admission for falls and hip fracture in elderly people vary by socio-economic status. Public Health 118:576–581PubMedCrossRef
9.
go back to reference Brennan nee Saunders J, Johansen A, Butler J et al (2003) Place of residence and risk of fracture in older people: a population-based study of over 65-year-olds in Cardiff. Osteoporos Int 14:515–519PubMedCrossRef Brennan nee Saunders J, Johansen A, Butler J et al (2003) Place of residence and risk of fracture in older people: a population-based study of over 65-year-olds in Cardiff. Osteoporos Int 14:515–519PubMedCrossRef
10.
go back to reference MacNab YC (2004) Bayesian spatial and ecological models for small-area accident and injury analysis. Accid Anal Prev 36:1019–1028PubMedCrossRef MacNab YC (2004) Bayesian spatial and ecological models for small-area accident and injury analysis. Accid Anal Prev 36:1019–1028PubMedCrossRef
11.
go back to reference Meliker JR, Maio RF, Zimmerman MA et al (2004) Spatial analysis of alcohol-related motor vehicle crash injuries in southeastern Michigan. Accid Anal Prev 36:1129–1135PubMedCrossRef Meliker JR, Maio RF, Zimmerman MA et al (2004) Spatial analysis of alcohol-related motor vehicle crash injuries in southeastern Michigan. Accid Anal Prev 36:1129–1135PubMedCrossRef
12.
go back to reference Nkhoma ET, Ed Hsu C, Hunt VI et al (2004) Detecting spatiotemporal clusters of accidental poisoning mortality among Texas counties, U.S., 1980–2001. Int J Health Geogr 3:25PubMedCrossRef Nkhoma ET, Ed Hsu C, Hunt VI et al (2004) Detecting spatiotemporal clusters of accidental poisoning mortality among Texas counties, U.S., 1980–2001. Int J Health Geogr 3:25PubMedCrossRef
14.
go back to reference Gelman A, Carlin JB, Stern HS et al (2003) Bayesian data analysis, 2nd edn. Chapman and Hall, Boca Raton Gelman A, Carlin JB, Stern HS et al (2003) Bayesian data analysis, 2nd edn. Chapman and Hall, Boca Raton
15.
go back to reference Boufous S, Finch C, Close J et al (2007) Hospital admissions following presentations to emergency departments for a fracture in older people. Inj Prev 13:211–214PubMedCrossRef Boufous S, Finch C, Close J et al (2007) Hospital admissions following presentations to emergency departments for a fracture in older people. Inj Prev 13:211–214PubMedCrossRef
16.
go back to reference Sugarman JR, Connell FA, Hansen A et al (2002) Hip fracture incidence in nursing home residents and community-dwelling older people, Washington State, 1993–1995. J Am Geriatrics Soc 50:1638–1643CrossRef Sugarman JR, Connell FA, Hansen A et al (2002) Hip fracture incidence in nursing home residents and community-dwelling older people, Washington State, 1993–1995. J Am Geriatrics Soc 50:1638–1643CrossRef
17.
go back to reference Gillespie LD, Gillespie WJ, Robertson MC et al (2003) Interventions for preventing falls in elderly people. The Cochrane Database of Systematic Reviews 4: CD000340. doi:10.1002/14651858.CD000340. Cited May 2006) Gillespie LD, Gillespie WJ, Robertson MC et al (2003) Interventions for preventing falls in elderly people. The Cochrane Database of Systematic Reviews 4: CD000340. doi:10.​1002/​14651858.​CD000340. Cited May 2006)
18.
go back to reference McClure R, Turner C, Peel N et al (2005) Population-based interventions for the prevention of fall-related injuries in older people. The Cochrane Database of Systematic Reviews 1:CD004441.pub2. doi:10.1002/14651858.CD004441.pub2 Cited May 2006 McClure R, Turner C, Peel N et al (2005) Population-based interventions for the prevention of fall-related injuries in older people. The Cochrane Database of Systematic Reviews 1:CD004441.pub2. doi:10.​1002/​14651858.​CD004441.​pub2 Cited May 2006
19.
go back to reference Butler M, Norton R, Lee-Joe T et al (1996) The risks of hip fracture in older people from private homes and institutions. Age Ageing 25:381–385PubMedCrossRef Butler M, Norton R, Lee-Joe T et al (1996) The risks of hip fracture in older people from private homes and institutions. Age Ageing 25:381–385PubMedCrossRef
20.
go back to reference Lawson AB, Browne WJ, Vidal Rodeiro CL (2003) Disease mapping with WinBUGS and MlwiN. Wiley, EnglandCrossRef Lawson AB, Browne WJ, Vidal Rodeiro CL (2003) Disease mapping with WinBUGS and MlwiN. Wiley, EnglandCrossRef
Metadata
Title
Spatial temporal modeling of hospitalizations for fall-related hip fractures in older people
Authors
R. M. Turner
A. Hayen
W. T. M. Dunsmuir
C. F. Finch
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 9/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0819-4

Other articles of this Issue 9/2009

Osteoporosis International 9/2009 Go to the issue