BACKGROUND: Very little has been studied about the incidence of fractures in nursing homes, their possible causes and the associated resident characteristics. METHODS: We reviewed reports of all incidents sent to the MA Dept of Public Health coded as 'injury-fracture' from January 1, 2000 to December 31, 2000 for named residents with a narrative that did not suggest an altercation between residents or overt physical mistreatment by staff. RESULTS: 906 cases met our criteria and for those who gender was given 177 were in men and 698 in women. For those whose age was reported the modeswere77 and 86 for men and women, respectively. Major injury sites included lower and upper extremities, hips, ribs and vertebrae. Incident circumstances were reported as unknown for 564 but other leading causes were witnessed fall or found on the floor (78 cases), transfer assisted by a nurse assistant (49 cases), involving a wheel chair, while a nurse assistant was providing ADLs and rare causes. Cognitive level was noted for 497 residents of which 64% were coded as either confused, diagnosed with Alzheimer's or another dementia; ADL status was noted for 419 residents for which 65% were dependent. CONCLUSIONS: While the bones of nursing home residents are fragile, it is possible that there are unreported events precipitating fractures and may include improper transfer techniques, rough handling, un-witnessed violence by other residents or staff or underutilization of protective measure such as wheelchair pedals. Fractures may represent a significant cause of morbidity among nursing home residents.
Learning Objectives: 1. Be able to estimate the number of fractures occuring in this population and the location of the fractures. 2. Realize that most are of unknown origin and those which do have reported causes may be due to modifiable causes.
Keywords: Elderly, Nursing Homes
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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.