The burden of osteoporotic fractures: A method for setting intervention thresholds
The burden of osteoporotic fractures: A method for setting intervention thresholds
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DOI：
10.1007/s001980170112
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发表时间：
2001-01-01
影响因子：
4
通讯作者：
Dawson, A
中科院分区：
文献类型：
--
作者：
Kanis, JA;Oden, A;Dawson, A
本研究的目的是根据瑞典人口的年龄和性别，评估髋部骨折和其他骨质疏松性骨折发病率之间的关系。骨质疏松性骨折被指定为与低骨矿物质密度（BMD）相关的骨折，以及50岁以后发生率随年龄增加而增加的骨折。骨折的严重程度根据其发病率加权，使用基于国家骨质疏松基金会得出的效用值。非髋部骨折的死亡率根据其负效用权重转换为髋部骨折等效物。50岁男性和女性的超额发病率分别为3.34和4.75，即与腰椎骨折相关的发病率是髋部骨折的3-5倍。在85至89岁之间，过量死亡率随年龄增加而下降至约1.25。假设骨质疏松症所致骨折的年龄和性别特异性模式在不同社区相似，则可利用超额发病率的计算来确定仅根据髋部骨折率的知识的骨质疏松性骨折的总发病率。这些数据可用于衡量不同国家髋部骨折的概率，以考虑髋部骨折以外骨折的发病率，并仅根据髋部骨折风险修改干预阈值。例如，如果将10年髋部骨折的概率为10%视为干预阈值，则在65岁及以上骨质疏松症女性中将超过该阈值，但当对其他骨质疏松性骨折进行加权时，所有骨质疏松症女性（和男性）都将超过该阈值。
The aim of this study was to assess the relationship between morbidity from hip fracture and that from other osteoporotic fractures by age and sex based on the population of Sweden. Osteoporotic fractures were designated as those associated with low bone mineral density (BMD) and those that increased in incidence with age after the age of 50 years. Severity of fractures was weighted according to their morbidity using utility values based on those derived by the National Osteoporosis Foundation. Morbidity from fractures other than hip fracture was converted to hip fracture equivalents according to their disutility weights. Excess morbidity was 3.34 and 4.75 in men and women at the age of 50 years, i.e. the morbidity associated with osteoporotic fractures was 3-5 times that accounted for by hip fracture. Excess moribidity decreased with age to approximately 1.25 between the ages of 85 and 89 years. On the assumption that the age- and sex-specific pattern of fractures due to osteoporosis is similar in different communities, the computation of excess morbidity can be utilized to determine the total morbidity from osteoporotic fractures from knowledge of hip fracture rates alone. Such data can be used to weight probabilities of hip fracture in different countries in order to take into account the morbidity from fractures other than hip fracture, and to modify intervention thresholds based on hip fracture risk alone. If, for example, a 10-year probability of hip fracture of 10% was considered an intervention threshold, this would be exceeded in women with osteoporosis aged 65 years and more, but when weighted for other osteoporotic fractures would be exceeded in all women (and men) with osteoporosis.