Hip fracture represents a serious and costly health problem for the elderly, and post-operative complications can retard rehabilitative efforts during acute hospitalization. A study was designed to determine the potential cost-savings of prevention of hip fractures in a representative sample of 7527 community dwelling persons, aged 70 and older, who were followed for six years. Four hundred twenty-eight hospitalizations for hip fracture among 370 persons have been reported to date, with 49 persons having multiple hospitalizations. The potential health care savings of prevention of these hip fractures are under investigation. In addition, a case series of 100 community dwelling patients with a diagnosis of hip fracture admitted to two hospitals was identified to determine mobility outcomes at discharge. Pressure ulcers were associated with prefracture assistance with Activities of Daily Living (ADL), over 80 years of age; pneumonia with male and prefracture urinary incontinence; urinary incontinence after urinary catheter removal with prefracture urinary incontinence and weight-bearing status; and straight catheterization for urinary retention with age greater than 80. The need for parallel bars or wheelchair versus a cane, crutch, or walker at discharge was associated with prefracture needs for assistance with ADL, prefracture depression, over 80 years of age, and straight catherization for urinary retention. Prefracture ADL status and weight-bearing status were associated with slow progress in post-fracture walking. Finally, post-operative incontinence was more prevalent in men than in women, and in cognitively- impaired individuals than in cognitively intact persons. The gender difference disappeared in the presence of cognitive impairment.
