Document Detail

Prediction of fracture in nursing home residents.
MedLine Citation:
PMID:  12164989     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To investigate cross-validated methods of identifying patients at increased risk of fracture in nursing homes using readily available data. DESIGN: Prospective cohort study with 18 months of follow-up. SETTING: Forty-seven randomly selected nursing homes in Maryland. PARTICIPANTS: One thousand four hundred twenty-seven white female nursing home residents aged 65 and older were followed for fracture for 18 months after baseline assessment. MEASUREMENTS: Fracture ascertained by physician note or x-ray from chart abstraction; demographic and baseline data extracted from the Minimum Data Set (MDS). RESULTS: Exploratory analyses on a random subset (67%) of the data (development sample) identified variables that might be important in predicting subsequent fracture and included variables for how the resident moved between locations in her room or adjacent corridor (mobility), age, weight, height, independence in eating and dressing, urinary incontinence, resistance to care, falls in the previous 6 months, a dementia score, and other activities of daily living. A simple scoring algorithm derived from a subset of these MDS variables showed good sensitivity (.70) but low specificity (.39) in the random validation sample. CONCLUSION: A scoring algorithm developed in more than 1,400 white females from 47 nursing homes in the state of Maryland shows high sensitivity for identifying women at increased risk for fracture and may be useful in targeting fracture prevention programs.
Cynthia J Girman; Julie M Chandler; Sheryl I Zimmerman; Allison R Martin; William Hawkes; J Richard Hebel; Philip D Sloane; Jay Magaziner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  50     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-07     Completed Date:  2002-09-26     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1341-7     Citation Subset:  IM    
Department of Epidemiology, Merck Research Laboratories, Blue Bell, Pennsylvania 19422, USA.
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MeSH Terms
Aged, 80 and over
Bone Density
Cohort Studies
Follow-Up Studies
Fractures, Bone / epidemiology,  prevention & control*
Homes for the Aged / statistics & numerical data*
Nursing Homes / statistics & numerical data*
Prospective Studies
Random Allocation
Risk Factors
Time Factors
Grant Support
Comment In:
Evid Based Nurs. 2003 Apr;6(2):58   [PMID:  12710433 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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