Fractures can lead to excruciating pain, immobility, and even mortality. People receiving home care are more prone tp fractures as compared to general population. As mentioned in this longitudinal cohort study, the Fracture Risk Scale for home care (FRS-HC) was useful in the estimation of incident hip fracture over 12 months. The outcomes of this study can be used to plan a support care by identifying home care recievers at high risk of fracture.

This study aimed to formulate a scale that forecasts 12 months incident of hip fracture with the help of a home care resident assessment instrument (RAI-HC).

Home care recipients were included. The RAI-HC used to retreive the clinical information and acquire 1-year incident hip fractures.

The drivation sample constitute of about 75% (n = 238,011) of the sample and, as for validation sample, it was 25% (n = 79,610). Decision tree was formed with the derivation sample via recognized fracture risk factors to devise 8 risk levels. The features of the full, derivation, and validation samples were assessed carefully via c-Statistics.

About 53% patients were aged 80 years and older and 60% of the sample were females.Overall, 11,526 (3.6%) fractures were captured over an year. Out of these, 5057 were fractures of the hip. The percentage of patients who experienced a hip fracture in the succeeding year ranged from 0.3% to 5.2% (lowest to highest risk level). The 8 risk levels of the Fracture Risk Scale – Home Care (FRS-HC) have been portryaed in the following figure:

Figure: Incident hip fracture rates as per individual decision nodes and the following 8 risk levels

The people in the highest risk level had 18.8 times higher odds of having a hip fracture within an year as compared to those in the lowest.The c-Statistics were similar for the full, derivation, and validation samples.

Over a period of 1 year, the FRS-HC predicts hip fracture should be used for home care receivers who are more prone to fracture.