ABSTRACT
Hip fractures have become an important cause of morbidity and mortality among adults all over the world. The objective of this study was to study epidemiological profile of hip fractures and assess the risk factors responsible for hip fractures in patients attending orthopaedics department of a tertiary care hospital in Bihar and to compare these factors with healthy control population. Methods: The present study was a retrospective case-control study conducted in a tertiary care hospital in Gaya, Bihar. Forty cases and forty controls were selected. Results: BMI was found to be statistically lower in the fracture group (p=0.035) as compared to controls. 67.5% of fractures were extra-capsular and 32.5% were intra-capsular. Overall, age 60-69 years showed the maximum burden of hip fractures. Fractures taking place indoors (62.5%) were higher than those occurring outdoors (37.5%). Physically active in the past (p=0.036) and alcohol usage (OR, 4.75; p= 0.045) were the factors which were significantly associated with the hip fracture. Conclusion: Hip fractures in Indian population are on a rising trend. Efforts should be made to reduce morbidities associated with hip fractures.
ABSTRACT
OBJECTIVES: This analytic retrospective case-control study was designed to analyze risk factors and the epidemiological profile of hip fractures among the Indian population with special importance to the mechanism of injuries. METHODS: Patients of hip fractures (n = 41) and age- and sex-matched healthy volunteers (n = 41) were interviewed by a questionnaire regarding the occurrence of the fracture, past history of diseases and long-term medication usage, past and physical activity, supplements, smoking, and alcohol intake. The data were tabulated using descriptive statistics and logistic regression was used to determine significant risk factors. RESULTS: Age group 60–69 was found to be most affected by hip fractures, though an early onset of fractures was noted in males. Falls due to slipping indoors from standing position was found very commonly. However, an increasing trend of falls was noted from lying down position in the older age groups which was more common during the morning and night hours. Logistic regression analysis for the detection of risk factors was applied to the various variables in the questionnaire. Active status in the past was inversely related (odds ratio [OR], 0.33; P < 0.05) to fracture risk while alternative medication usage in the past 1 year (OR, 4.086; P < 0.05) and significant alcohol consumption were directly associated with fracture risk (OR, 5.484; P < 0.05). A potential inverse relation of use of calcium supplements in the past 3 months and fracture risk (OR, 0.872) was seen, although this was not significant. A potential positive relation of smoking with hip fractures was also seen, but not found significant (OR, 2.204). CONCLUSIONS: Hip fractures in the elderly population are on a rising trend especially in the Indian subcontinent due to a number of factors both hereditary and acquired. Simple measures like routine usage of bedside railing, wall-side railings at an appropriate height, high friction tiles inside rooms and washrooms, and adequate lighting indoors can play a significant role in reducing falls and hip fractures among the elderly.