The 130th Annual Meeting of APHA

Abstract #49542

Carlos Arturo Camargo, MD, DrPH and Nan Wang. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Clinics Building 397, Boston, MA 02114, (617) 726-5276, ccamargo@partners.org

OBJECTIVE: To describe the epidemiology of emergency department (ED) visits for hip fracture. METHODS: Data were obtained from the 1992-1999 National Hospital Ambulatory Medical Care Survey. Analyses included all visits age 50+ with ICD-9 codes 820.0-820.9. National estimates were obtained using assigned patient visit weights. 95% CI were calculated using the relative standard error of the estimate. Rates were calculated using population data from the US Census Bureau, with all rates reported per 1,000 per year for US population. Regression was used for trend analysis. RESULTS: From 1992-1999, there were an estimated total of 1,772,000 ED visits for hip fracture, for a rate of 3.2 (95% CI 3.1-3.4) visits per year per 1,000 people. Both the total number of ED visits and the ED visit rates remained stable between 1992-1999 (p for trend=0.48 and 0.80, respectively). The ED visit rate was highest for age >80 years (16.1, 95% CI 15.0-17.1). Rates were higher among women (4.4) than men (1.7), and among whites (3.5) than blacks (1.3). The South region had the lowest visit rates (2.9), while the Midwest had the highest (3.7). Although 84% of visits resulted in hospitalization, only 54% had documentation of analgesic use. 88% of visits had falls listed as the cause of the injury, with 68% of falls occurring at a residence. CONCLUSION: ED visits for hip fracture are common, and remain a significant problem for elderly white women. The ED visit presents an untapped opportunity for focused efforts in hip fracture prevention.

Learning Objectives:

• Describe ED visits for hip fracture
• Discuss treatment practice and potential future efforts to reduce the number of hip fractures
• Create a plan to better treat hip fractures and potentially use the ED as a place to disseminate information to prevent hip fractures in the future.

Keywords: Emergency Department/Room, Elderly

Related Web page: healthcare.partners.org/marc/marc.htm

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.