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Previous Volume 330:1555-1559 June 2, 1994 Number 22 Next

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ABSTRACT

Background Although more than 1 percent of black women 80 years of age or older have hip fractures each year, little is known about risk factors for hip fracture in these women.

Methods We carried out a case-control study involving 144 black women admitted with a first hip fracture to 1 of 30 hospitals in New York and Philadelphia. The controls were 218 black women living in the community who were matched to the case patients according to age and ZIP Code or telephone exchange and 181 hospitalized black women matched according to age and hospital. Information was obtained through personal interviews and was studied by multivariable logistic-regression analysis.

Results When the case patients were compared with the control subjects from the community, the women in the lowest quintile for body-mass index had a markedly increased risk of hip fracture as compared with the women in the highest quintile (odds ratio, 13.5; 95 percent confidence interval, 4.2 to 43.3). Postmenopausal estrogen therapy for one year or more was protective for women under 75 years of age (odds ratio, 0.1; 95 percent confidence interval, <0.1 to 0.5). Factors associated with an increased risk of hip fracture included a history of stroke (odds ratio, 3.1; 95 percent confidence interval, 1.2 to 8.1), use of aids in walking (odds ratio, 5.6; 95 percent confidence interval, 2.7 to 11.5), and consumption of seven or more alcoholic drinks per week (odds ratio, 4.6; 95 percent confidence interval, 1.5 to 14.1). The results were similar when the case patients were compared with the hospitalized control subjects.

Conclusions Among black women thinness, previous stroke, use of aids in walking, and alcohol consumption are associated with an increased risk of hip fracture. Postmenopausal estrogen therapy protects against hip fracture in women under 75 years of age.

Source Information

From the Center for Clinical Epidemiology and Biostatistics, Division of General Internal Medicine, School of Medicine, University of Pennsylvania, Philadelphia (J.A.G., B.L.S., L.A.O., G.M., K.L.); the Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, Calif. (J.L.K.); and the Division of Epidemiology, Columbia University, New York (L.S., S.H.). The Northeast Hip Fracture Study Group includes, in Philadelphia, Dr. James Anthony and Dr. Alan Hibberd, Mercy Catholic Medical Center; Dr. Michael Clancy, Temple University Health Sciences Center; Dr. Jerome Cotler, Jefferson University Hospital; Dr. William DeLong, Cooper Hospital/ University Medical Center; Dr. Malcolm Ecker, Chestnut Hill Hospital; Dr. Z.B. Friedenberg, Presbyterian-University of Pennsylvania Medical Center; Dr. Robert Good, Bryn Mawr Hospital; Dr. Charles Hummer, Crozer-Chester Medical Center and Sacred Heart Hospital; Dr. David Junkin, Abington Hospital; Dr. William Markman, Jeanes Hospital; Dr. Pekka Mooar, Medical College of Pennsylvania; Dr. Herbert Stein, Frankford Hospital; Dr. Milton Wohl, Albert Einstein Medical Center; Dr. Brendan Wynne, Philadelphia College of Osteopathic Medicine; and Dr. Dennis Zaslow, St. Joseph's Hospital; and in New York, Dr. David Andrews, Allen Pavilion; Dr. Harold Dick, Columbia-Presbyterian Medical Center; Dr. Edward Habermann, Montefiore Medical Center; Dr. Harvey Insler, Bronx-Lebanon Hospital Center; Dr. Placido Menezes, Interfaith Medical Center; Dr. Ronald Rosenthal, Long Island Jewish Medical Center; Dr. Arthur Sadler, Jacobi Hospital; Dr. Marvin Shelton, Harlem Hospital; Dr. Joel Teicher, Brookdale Hospital Medical Center; and Dr. Robert Zickel, St. Luke's-Roosevelt Hospital Center.

Address reprint requests to Dr. Grisso at the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 317R Nursing Education Bldg., 420 Service Dr., Philadelphia, PA 19104-6095.

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