Determinants of fracture risk in a UK-population-based cohort of older women: a cross-sectional analysis of the Cohort for Skeletal Health in Bristol and Avon (COSHIBA)
Determinants of fracture risk in a UK-population-based cohort of older women: a cross-sectional analysis of the Cohort for Skeletal Health in Bristol and Avon (COSHIBA)
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DOI：
10.1093/ageing/afr132
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发表时间：
2012-01-01
期刊：
影响因子：
6.7
通讯作者：
Tobias, Jon
中科院分区：
文献类型：
--
作者：
Clark, Emma M.;Gould, Virginia C.;Tobias, Jon
背景：从初级保健中识别具有高骨折风险的个体是复杂的。很可能跌倒对骨折风险的真正贡献被低估了。方法：对3,200名年龄73+/-4岁的绝经后妇女进行基于人群的横断面分析。收集关于骨折、骨质疏松症临床危险因素和跌倒/活动危险因素的自我报告数据。将自我报告的跌倒与全科医生电脑记录中记录的跌倒进行比较。结果：共有838人(26.2%)在50岁后报告骨折；441人每年摔倒一次以上，但69%的人在其计算机GP记录中没有提到摔倒。只有年龄[优势比(OR)：每5年增加1.37，95%可信区间(CI)：1.23~1.53]、身高(每厘米增加1.02，95%可信区间：1.01~1.04)、体重(OR：每公斤增加0.99，95%CI：0.98~0.99)和跌倒(OR：1.49，与之比较，95%CI：1.13~1.94)是骨折的独立危险因素。结论：在确定骨折风险高的个体时，我们估计每年一次以上的跌倒的重要性至少是身高和体重的两倍。此外，使用自我报告的跌倒数据是至关重要的，因为计算机化的全科医生记录低估了跌倒的患病率。
Background: identification of individuals with high fracture risk from within primary care is complex. It is likely that the true contribution of falls to fracture risk is underestimated.Methods: cross-sectional analysis of a population-based cohort of 3,200 post-menopausal women aged 73 +/- 4 years. Self-reported data were collected on fracture, osteoporosis clinical risk factors and falls/mobility risk factors. Self-reported falls were compared with recorded falls on GP computerised records. Multivariable logistic regression was used to identify independent risk factors for fracture.Results: a total of 838 (26.2%) reported a fracture after aged 50; 441 reported falling more than once per year, but 69% of these had no mention of falls on their computerised GP records. Only age [odds ratios (OR): 1.37 per 5 year increase, 95% confidence interval (CI): 1.23-1.53], height (1.02 per cm increase, 95% CI: 1.01-1.04), weight (OR: 0.99 per kg increase, 95% CI: 0.98-0.99) and falls (OR: 1.49 for more than once per year compared with less, 95% CI: 1.13-1.94) were independent risk factors for fracture. Falls had the strongest association.Conclusion: when identifying individuals with high fracture risk we estimate that more than one fall per year is at least twice as important as height and weight. Furthermore, using self-reported falls data is essential as computerised GP records underestimate falls prevalence.