Hip fracture and increased short-term but not long-term mortality in healthy older women.
Hip fracture and increased short-term but not long-term mortality in healthy older women.
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DOI：
10.1001/archinternmed.2011.447
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发表时间：
2011-11-14
影响因子：
--
通讯作者：
Browner WS
中科院分区：
文献类型：
--
作者：
LeBlanc ES;Hillier TA;Pedula KL;Rizzo JH;Cawthon PM;Fink HA;Cauley JA;Bauer DC;Black DM;Cummings SR;Browner WS
骨折与随后的死亡率增加有关，但不清楚这种增加会持续多久。来自美国大型社区多中心前瞻性队列9704名（骨质疏松性骨折研究）的5580名女性进行了近20年的前瞻性随访。我们将1116例髋部骨折病例与4例对照（n=4464）进行年龄匹配。为了检查健康状况的影响，我们检查了一个80岁以上的健康老年人子集（n=960），他们参加了10年的随访检查，并报告健康状况良好/非常好。偶发性髋部骨折由研究医师根据放射学报告判定。死亡证明证实了死亡。髋部骨折病例在骨折后一年的死亡率是对照组的两倍[16.9% vs. 8.4%；优势比(OR)=2.4；95%置信区间（CI） 1.9, 3.1]。按年龄和健康状况检查，65 ~ 70岁（16.3% vs 3.7%； OR=5.0; 2.6, 9.5）、70 ~ 79岁（16.5% vs 8.9%； OR=2.4; 1.8, 3.3）和仅在健康状况良好/极好的80岁以上（15.1% vs 7.2%； OR=2.8; 1.5, 5.2）短期死亡率增加。一年后，除了65至70岁的患者死亡率继续增加外，髋部骨折患者和对照组的生存率相似。65岁至79岁的妇女和80岁以上非常健康的妇女髋部骨折后的短期死亡率增加。70岁及以上的妇女在一年后恢复到以前的风险水平。需要采取干预措施来降低髋部骨折后一年的死亡率，这是死亡率最高的一年。
Fractures have been associated with subsequent increases in mortality, but it is unknown how long that increase persists. 5580 women from a large community-based multicenter US prospective cohort of 9704 (Study of Osteoporotic Fractures) were followed prospectively for almost 20 years. We age-matched 1116 hip fracture cases with four controls (n=4464). To examine the effect of health status, we examined a healthy older subset (n=960) aged 80+ who attended the 10-year follow-up examination, and reported good/excellent health. Incident hip fractures were adjudicated from radiology reports by study physicians. Death was confirmed by death certificates. Hip fracture cases had two-fold increased mortality in the year after fracture compared to controls [16.9% vs. 8.4%; Odds Ratio (OR)=2.4; 95% Confidence Interval (CI) 1.9, 3.1]. When examined by age and health status, short-term mortality was increased in those aged 65 to 70 (16.3% vs 3.7%; OR=5.0; 2.6, 9.5), aged 70 to 79 (16.5% vs 8.9%; OR=2.4; 1.8, 3.3), and only in aged 80+ with good/excellent health (15.1% vs. 7.2%; OR=2.8; 1.5, 5.2). After the first year, survival of hip fracture cases and controls was similar except in those aged 65 to 70 who continued to have increased mortality. Short-term mortality is increased after hip fracture in women aged 65 to 79 and in exceptionally healthy women 80 or older. Women 70 and older return to previous risk levels after a year. Interventions are needed to decrease mortality in the year after hip fracture, when mortality risk is highest.
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DOI：
10.1016/j.injury.2008.03.022
发表时间：
2008-10-01
影响因子：
2.5
作者：
Haleem, S.;Lutchman, L.;Parker, M. J.
通讯作者：
Parker, M. J.
影响因子：
4
作者：
Farahmand, BY;Michaëlsson, K;Baron, JA
通讯作者：
Baron, JA
影响因子：
4
作者：
Meyer, HE;Tverdal, A;Pedersen, JI
通讯作者：
Pedersen, JI
影响因子：
120.7
作者：
NELSON, HD;NEVITT, MC;CUMMINGS, SR
通讯作者：
CUMMINGS, SR
影响因子：
4
作者：
Forsén, L;Sogaard, AJ;Kopjar, B
通讯作者：
Kopjar, B