After a fracture in a care home, 4% got a bisphosphonate and 73% a falls-risk drug

The edition in brief

In 192,118 US nursing home residents with a recent hip or other fracture (2017 to 2022), only 4.2% had an oral bisphosphonate prescription while 72.8% were taking at least one drug linked to injurious falls, most often statins (31.1%), opioids (26.7%), newer anticonvulsants (22.1%) and loop diuretics (22.1%); osteoporosis was recorded in 18.8%. In 11.8 million hospitalised adults aged 65 or over, interhospital transfer was associated with higher in-hospital mortality (adjusted OR 1.91) and 30-day readmission (adjusted OR 1.29). The surgical Risk Analysis Index kept strong discrimination for 180-day mortality in 600,000 patients a decade after calibration (c 0.83 to 0.87), and recalibration added little. A model of adjuvanted RSV prefusion F3 vaccination in US long-term care residents estimated 11,634 fewer hospitalisations and 1,355 fewer deaths over five years, with 14 vaccinated per lower respiratory case avoided. A multidomain dementia-prevention programme did not reduce weight in 678 older adults with overweight. The pearl covers measuring orthostatic hypotension.