{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:22:00Z","timestamp":1762176120123,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["1R01AG045441"],"award-info":[{"award-number":["1R01AG045441"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND\/OBJECTIVES<\/jats:title>\n                    <jats:p>Limited studies suggest lower\u2010extremity (LE) fractures are morbid events for nursing home (NH) residents. Our objective was to conduct a nationwide study comparing the incidence and resident characteristics associated with hip (proximal femur) vs nonhip LE (femoral shaft and tibia\u2010fibula) fractures in the NH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>US NHs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>We included all long\u2010stay residents, aged 65\u2009years or older, enrolled in Medicare from January 1, 2008, to December 31, 2009 (N\u2009= 1 257 279). Residents were followed from long\u2010stay qualification until the first event of LE fracture, death, or end of follow\u2010up (2 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>Fractures were classified using Medicare diagnostic and procedural codes. Function, cognition, and medical status were obtained from the Minimum Data Set prior to long\u2010stay qualification. Incidence rates (IRs) were calculated as the total number of fractures divided by person\u2010years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      During 42 800 person\u2010years of follow\u2010up, 52 177 residents had an LE fracture (43 695 hip, 6001 femoral shaft, 2481 tibia\u2010fibula). The unadjusted IRs of LE fractures were 1.32\/1000 person\u2010years (95% confidence interval [CI] = 1.27\u20101.38) for tibia\u2010fibula, 3.20\/1000 person\u2010years (95% CI = 3.12\u20103.29) for femoral shaft, and 23.32\/1000 person\u2010years (95% CI = 23.11\u201023.54) for hip. As compared with hip fracture residents, non\u2010hip LE fracture residents were more likely to be immobile (58.1% vs 18.4%), to be dependent in all activities of daily living (31.6% vs 10.8%), to be transferred mechanically (20.5% vs 4.4%), to be overweight (mean body mass index = 26.6 vs 24.0 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), and to have diabetes (34.8% vs 25.7%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Our findings that non\u2010hip LE fractures often occur in severely functionally impaired residents suggest these fractures may have a different mechanism of injury than hip fractures. The resident differences in our study highlight the need for distinct prevention strategies for hip and non\u2010hip LE fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15825","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T19:38:46Z","timestamp":1551296326000},"page":"1253-1257","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Incidence of Lower\u2010Extremity Fractures in US Nursing Homes"],"prefix":"10.1111","volume":"67","author":[{"given":"Kathryn","family":"Sine","sequence":"first","affiliation":[{"name":"Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoojin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy and Practice, School of Public Health Brown University Providence Rhode 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