title: Hip fracture in hospitalized medical patients.
abstract: BACKGROUND
  The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain.
  
  
  METHODS
  We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization.Outcome measures included rates of in-hospital fractures, length of stay and cost.
  
  
  RESULTS
  A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p < 0.001, and the mean length of stay was significantly longer for patients with a hip fracture (20.7 days vs 9.8 days; p < 0.001). Cost were higher in hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49).
  
  
  CONCLUSIONS
  In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
authors.forename: Antonio
authors.initials: A
authors.lastname: Zapatero
authors.forename: Raquel
authors.initials: R
authors.lastname: Barba
authors.forename: Jesús
authors.initials: J
authors.lastname: Canora
authors.forename: Juan E
authors.initials: JE
authors.lastname: Losa
authors.forename: Susana
authors.initials: S
authors.lastname: Plaza
authors.forename: Jesús
authors.initials: J
authors.lastname: San Roman
authors.forename: Javier
authors.initials: J
authors.lastname: Marco
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006620:Hip Fractures / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D006707:Homes for the Aged; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D007388:Internal Medicine / Q000191:economics / Q000706:statistics & numerical data*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D016017:Odds Ratio; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors