title: The Elders Risk Assessment Index, an electronic administrative database-derived frailty index, can identify risk of hip fracture in a cohort of community-dwelling adults.
abstract: OBJECTIVE
  To determine whether an Elders Risk Assessment (ERA) index can predict incident hip fractures without the need for physician-patient encounter or bone mineral density testing.
  
  
  METHODS
  A retrospective cohort study was conducted in a community-based cohort of 12,650 patients aged 60 years and older. An ERA score was computed for each subject at index time (January 1, 2005). Incidents of hip fracture from January 1, 2005, through December 31, 2006, were obtained from electronic medical records. We divided the cohort into 5 groups, with the lowest ERA scores forming group A (<15%); 15% to 49%, group B; 50% to 74%, group C; 75% to 89%, group D; and the top 11%, group E. With group A as a reference group, we used logistic regression to compute odds ratios of sustaining hip fracture during a 2-year period (January 1, 2005, through December 31, 2006) for groups B, C, D, and E. Sensitivity and specificity of each possible ERA score were calculated, and a receiver operating characteristic curve was created.
  
  
  RESULTS
  Two hundred sixty-five patients (2.1%) sustained at least 1 hip fracture from January 1, 2005, through December 31, 2006. Odds ratios (95% confidence intervals) for groups B, C, D, and E were 1.6 (0.7-3.4), 4.5 (2.2-9.4), 6.9 (3.3-14.3), and 18.4 (8.9-37.9), respectively. The area under the receiver operating characteristic curve was 74.5%.
  
  
  CONCLUSIONS
  An electronic medical record-based, easily derived ERA index might be useful in hip fracture risk stratification.
authors: Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. albaba.mohammad@mayo.edu
authors: Mohammad
authors: M
authors: Albaba
authors: Stephen S
authors: SS
authors: Cha
authors: Paul Y
authors: PY
authors: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity