Abstract：
BACKGROUND: Proximal femoral fractures in older adults affect prognosis, quality of life and medical expenses. Therefore, identifying patients with an elevated risk for proximal femoral fractures and implementing preventive measures to mitigate their occurrence are crucial.
OBJECTIVE: This study aimed to develop an accurate in-hospital fracture prediction model that considers patients\' daily conditions and medical procedure status. Additionally, it investigated the changes in their conditions associated with fractures during hospital stays.
METHODS: A retrospective observational study.
METHODS: Acute care hospitals in Japan.
METHODS: Participants were 8 514 551 patients from 1321 medical facilities who had been discharged between April 2018 and March 2021 with hip and proximal femoral fractures.
METHODS: Logistic regression analysis determined the association between patients\' changes in their ability to transfer at admission and the day before fracture, and proximal femoral fracture during hospital stays.
RESULTS: Patients were classified into fracture and non-fracture groups. The mean ages were 77.4 (SD: 7.7) and 82.6 (SD: 7.8), and the percentages of women were 42.7% and 65.3% in the non-fracture and fracture groups (p<0.01), respectively. Model 4 showed that even if a patient required partial assistance with transfer on the day before the fracture, the fracture risk increased in each category of change in ability to transfer in the following order: \'declined\', \'improved\' and \'no change\'.
CONCLUSIONS: Patients showing improved ability to transfer during their hospitalisation are at a higher risk for fractures. Monitoring patients\' daily conditions and tracking changes can help prevent fractures during their hospital stays.
OBJECTIVE: This study aimed to develop an accurate in-hospital fracture prediction model that considers patients\' daily conditions and medical procedure status. Additionally, it investigated the changes in their conditions associated with fractures during hospital stays.
METHODS: A retrospective observational study.
METHODS: Acute care hospitals in Japan.
METHODS: Participants were 8 514 551 patients from 1321 medical facilities who had been discharged between April 2018 and March 2021 with hip and proximal femoral fractures.
METHODS: Logistic regression analysis determined the association between patients\' changes in their ability to transfer at admission and the day before fracture, and proximal femoral fracture during hospital stays.
RESULTS: Patients were classified into fracture and non-fracture groups. The mean ages were 77.4 (SD: 7.7) and 82.6 (SD: 7.8), and the percentages of women were 42.7% and 65.3% in the non-fracture and fracture groups (p<0.01), respectively. Model 4 showed that even if a patient required partial assistance with transfer on the day before the fracture, the fracture risk increased in each category of change in ability to transfer in the following order: \'declined\', \'improved\' and \'no change\'.
CONCLUSIONS: Patients showing improved ability to transfer during their hospitalisation are at a higher risk for fractures. Monitoring patients\' daily conditions and tracking changes can help prevent fractures during their hospital stays.
摘要：
背景：老年人股骨近端骨折影响预后，生活质量和医疗费用。因此,确定股骨近端骨折风险升高的患者并实施预防措施以减轻其发生至关重要.
目的：本研究旨在开发一种准确的院内骨折预测模型，该模型考虑患者的日常状况和医疗程序状态。此外,它调查了住院期间与骨折相关的病情变化。
方法：回顾性观察研究。
方法：日本的急性护理医院。
方法：参与者是来自1321家医疗机构的8514551例患者，他们在2018年4月至2021年3月期间因髋部和股骨近端骨折出院。
方法：Logistic回归分析确定患者入院时和骨折前一天转移能力的变化之间的关联，住院期间股骨近端骨折。
结果：患者分为骨折组和非骨折组。平均年龄为77.4（SD：7.7）和82.6（SD：7.8），非骨折组和骨折组女性比例分别为42.7%和65.3%(p<0.01),分别。模型4显示，即使患者在骨折前一天需要部分协助转移，在转移能力的每一类变化中，骨折风险都按以下顺序增加：“下降”，\'改进\'和\'没有更改\'。
结论：住院期间转移能力改善的患者骨折风险较高。监测患者的日常状况和跟踪变化可以帮助预防住院期间的骨折。
目的：本研究旨在开发一种准确的院内骨折预测模型，该模型考虑患者的日常状况和医疗程序状态。此外,它调查了住院期间与骨折相关的病情变化。
方法：回顾性观察研究。
方法：日本的急性护理医院。
方法：参与者是来自1321家医疗机构的8514551例患者，他们在2018年4月至2021年3月期间因髋部和股骨近端骨折出院。
方法：Logistic回归分析确定患者入院时和骨折前一天转移能力的变化之间的关联，住院期间股骨近端骨折。
结果：患者分为骨折组和非骨折组。平均年龄为77.4（SD：7.7）和82.6（SD：7.8），非骨折组和骨折组女性比例分别为42.7%和65.3%(p<0.01),分别。模型4显示，即使患者在骨折前一天需要部分协助转移，在转移能力的每一类变化中，骨折风险都按以下顺序增加：“下降”，\'改进\'和\'没有更改\'。
结论：住院期间转移能力改善的患者骨折风险较高。监测患者的日常状况和跟踪变化可以帮助预防住院期间的骨折。
