Epidemiology of Pelvic Fractures in Germany: Considerably High Incidence Rates among Older People.
Epidemiology of Pelvic Fractures in Germany: Considerably High Incidence Rates among Older People.
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DOI：
10.1371/journal.pone.0139078
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Icks A
中科院分区：
文献类型：
--
作者：
Andrich S;Haastert B;Neuhaus E;Neidert K;Arend W;Ohmann C;Grebe J;Vogt A;Jungbluth P;Rösler G;Windolf J;Icks A
有关骨盆骨折的流行病学数据有限。到目前为止，大多数研究只分析住院患者的数据。本研究的目的是根据门诊和住院数据，估计60岁或以上德国人群骨盆骨折的发病率。我们根据德国一家大型健康保险公司的常规数据进行了一项回顾性的基于人群的观察性研究。计算了2008年至2011年期间首次骨折的年龄和性别特异性发病率。我们还对德国人群的年龄和性别的发病率进行了标准化。采用多重Poisson回归模型评估首次骨盆骨折风险与性别、年龄、历年和地区之间的关系。首次骨盆骨折的患者总数为8，041人，在研究期间，有5，978名投保人需要住院治疗。总体而言，所有首次骨盆骨折的标准化发生率为22.4 [95% CI 22.0-22.9]/10，000人-年，住院治疗骨折的标准化发生率为16.5 [16.1-16.9]。我们的校正回归分析证实了性别（RR 2.38 [2.23-2.55]，p < 0.001，男性作为参考）和年龄（随着年龄的增加，风险更高，p < 0.001）对首次骨折风险的显著影响。我们发现日历年（与2008年相比，以后年份的风险更高，p = 0.0162）与首次骨折风险之间存在轻微相关性，并且与地区之间存在进一步的显著相关性（RR 0.92 [0.87-0.98]，p = 0.006，Westfalen-Lippe作为参考）。即使仅考虑住院治疗的骨盆骨折，观察到的发生率也远高于国际文献中描述的发生率。此外，未纳入门诊数据意味着未考虑骨盆骨折的相关比例。预防老年人的低能量创伤仍然是一个重要问题。
Epidemiological data about pelvic fractures are limited. Until today, most studies only analyzed inpatient data. The purpose of this study was to estimate incidence rates of pelvic fractures in the German population aged 60 years or older, based on outpatient and inpatient data. We conducted a retrospective population-based observational study based on routine data from a large health insurance company in Germany. Age and sex-specific incidence rates of first fractures between 2008 and 2011 were calculated. We also standardized incidence rates with respect to age and sex in the German population. Multiple Poisson regression models were used to evaluate the association between the risk of first pelvic fracture as outcome and sex, age, calendar year and region as independent variables. The total number of patients with a first pelvic fracture corresponded to 8,041 and during the study period 5,978 insured persons needed inpatient treatment. Overall, the standardized incidence rate of all first pelvic fractures was 22.4 [95% CI 22.0–22.9] per 10,000 person-years, and the standardized incidence rate of inpatient treated fractures 16.5 [16.1–16.9]. Our adjusted regression analysis confirmed a significant sex (RR 2.38 [2.23–2.55], p < 0.001, men as reference) and age effect (higher risk with increasing age, p < 0.001) on first fracture risk. We found a slight association between calendar year (higher risk in later years compared to 2008, p = 0.0162) and first fracture risk and a further significant association with region (RR 0.92 [0.87–0.98], p = 0.006, Westfalen-Lippe as reference). The observed incidences are considerably higher than incidences described in the international literature, even if only inpatient treated pelvic fractures are regarded. Besides which, non-inclusion of outpatient data means that a relevant proportion of pelvic fractures are not taken into account. Prevention of low energy trauma among older people remains an important issue.