Characteristics of elderly patients admitted to an urban tertiary care hospital with osteoporotic fractures: correlations with risk factors, fracture type, gender and ethnicity
Characteristics of elderly patients admitted to an urban tertiary care hospital with osteoporotic fractures: correlations with risk factors, fracture type, gender and ethnicity
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DOI：
10.1007/s00198-005-0001-1
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发表时间：
2006-03-01
影响因子：
4
通讯作者：
Siris, E
中科院分区：
文献类型：
--
作者：
Becker, C;Crow, S;Siris, E
骨质疏松症是美利坚合众国和世界各地的一个主要公共卫生问题，主要是由于与骨质疏松性骨折有关的发病率和死亡率。在过去的十年中，大型流行病学研究极大地促进了我们对骨折患者的理解。然而，大多数研究仅限于绝经后的白人妇女。在这篇回顾性综述中，我们分析了2001年至2003年间在一家城市医院接受骨质疏松咨询的185名急性脆性骨折患者的数据。男性和女性在跌倒和骨质疏松的危险因素方面存在差异，但实际骨密度（BMD）测量结果非常相似，除了整个髋关节。黑人和西班牙裔骨折患者明显比白人年轻，但更有可能出现严重的合并症，如糖尿病和高血压。尽管骨密度测量值明显较高，但黑人患者维生素D缺乏症和继发性甲状旁腺功能亢进症的发病率最高。入院的髋部骨折患者与非髋部骨折患者在许多重要变量上有所不同。基于这些数据，我们得出结论，在城市医院接受骨质疏松性骨折的老年受试者是一个异质性群体，其特征因骨折类型、性别和种族而异。未来对临床脆性骨折患者的研究应包括足够数量的男性和少数民族，因为潜在危险因素的差异可能提示骨折预防的替代策略。
Osteoporosis is a major public health problem in the United States of America and around the world, largely due to the morbidity and mortality associated with osteoporotic fractures. In the past decade, large epidemiologic studies have contributed greatly to our understanding of patients who fracture. However, most studies are limited to postmenopausal white women. In this retrospective review, we analyze data from 185 men and women with acute fragility fractures who received osteoporosis consultations during admission to a single urban hospital between 2001 and 2003. Men and women differed in terms of risk factors for falls and osteoporosis but had areal bone mineral density (BMD) measurements remarkably similar, except at the total hip. Black and Hispanic subjects with fractures were significantly younger than whites yet were much more likely to have serious co-morbidities, such as diabetes mellitus and hypertension. In spite of significantly higher BMD measurements, black patients had the highest rates of vitamin D deficiency and secondary hyperparathyroidism. Patients admitted with hip fractures differed from those with non-hip fractures on a number of important variables. Based on these data, we conclude that elderly subjects admitted to an urban hospital with osteoporotic fractures are a heterogeneous group, with features that vary according to fracture type, gender and ethnicity. Future studies of patients with clinical fragility fractures should include ample numbers of men and ethnic minorities, since differences in underlying risk factors may suggest alternative strategies for fracture prevention.