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Epidemiology of bone fractures occurring during hospitalization
M D Nettleman1, R P Wenzel, J R Adams
1University of Iowa Hospitals and Clinics, Iowa City 52242.
Objective:
To investigate the incidence and epidemiology of nosocomial bone fractures.
Design:
Observational, case series.
Setting:
Tertiary care center.
Patients:
All patients sustaining a fracture during hospitalization during the 18-month study period from July 1989 through December 1990.
Results:
Twenty nosocomial fractures were identified. Twelve of these resulted from falls (3.5 fractures from falls/100,000 patient days). Fracture rates were higher on the neurology service than on other services. Patients who fell and sustained a fracture were significantly older than patients who fell but did not sustain a fracture (74 versus 58 years, respectively, p < .05). Falls occurring on weekends and holidays were approximately three times more likely to result in fracture than falls occurring on other days (p = .06).
Conclusions:
Nosocomial fractures were infrequent events but were more common in the elderly and in persons with significant neuropsychological impairment. Persons who sustained fractures during hospitalization were similar to those who fell and fractured bones in a community setting.