Do hip protectors decrease the risk of hip fracture in institutional- and community-dwelling elderly? A systematic review and meta-analysis of randomized controlled trials/
Sawka, Anna M; Boulos, Pauline; Beattie, Karen; Thabane, Lehana; Papaioannou, Alexandra; Gafni, Amiram; Cranney, Ann; Zytaruk, Nicole; Hanley, David A; Adachi, Jonathan D.
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Hip fractures are an important cause of morbidity and mortality in the elderly. Hip protectors are padded undergarments designed to decrease the impact of a fall on the hip. We systematically reviewed randomized controlled trials of hip protectors to determine if they reduce hip fractures in the elderly. Analyses were pooled according to participant residence (community or institutional), incorporating individually randomized and statistically adjusted cluster randomized trials. Eight trials of 12- to 28-month duration were included. The Safehip brand of hip protector was used in most studies. Compliance rates in the treatment groups were 31–70%. In four trials including a total of 5,696 community-dwelling seniors, the hip fracture rates in control groups ranged from 1.1 to 7.4% and the pooled risk difference with hip protector allocation was 0% [95% confidence intervals (CI), –1%, +1%), with a relative risk of 1.07 (0.81, 1.42). In four trials including 1,352 institutionalized elderly participants, hip fractures rates in the control groups ranged from 8 to 19.4% and the pooled risk difference for sustaining one or more hip fractures with hip protector allocation was –4.0% (95% CI, –7.5%, –0.5%), with a relative risk of 0.53 (0.30, 0.96) (with statistically significant heterogeneity of treatment effect). The number of institutionalized elderly people needing to be treated to prevent one or more hip fractures per person is 25 (95% CI, 13, 200). Thus, there is evidence that hip protectors reduce hip fracture risk in institutionalized elderly but insufficient evidence to support their use in lower risk community dwelling seniors.
Factors de risc Fractures de maluc Metanŕlisi Persones grans