External hip protectors are effective for the elderly with higher-than-average risk factors for hip fractures
External hip protectors are effective for the elderly with higher-than-average risk factors for hip fractures
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DOI：
10.1007/s00198-008-0824-7
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发表时间：
2009-09-01
影响因子：
4
通讯作者：
Takaoka, K.
中科院分区：
文献类型：
--
作者：
Koike, T.;Orito, Y.;Takaoka, K.
在我们对672名非卧床老年妇女进行的髋关节保护器有效性的随机对照试验中，髋关节保护器对有跌倒史的居民预防髋关节骨折更有效（n = 202;风险比（HR），0.375; 95%CI，0.14-0.98; p = 0.05）和体重指数（BMI）a千分之一货币符号欧元千分之19.0（n = 206; HR，0.37; 95%CI，0.14-0.95; p = 0.04）通过考克斯比例风险回归模型。一个潜在的成本效益的方法，以防止髋部骨折涉及使用髋关节保护器，但最近的研究表明，髋关节保护器的不确定的有效性，即使在机构settings.This研究是一个集群随机对照试验与疗养院。我们随机分配了76个家庭，672个走动，但体弱的老年妇女。在基线时评估了几个风险因素，并将其纳入考克斯比例风险回归模型。UMIN临床试验注册编号为UMIN 00000467。研究期间为2004年1月至2006年3月。干预组发生19例髋部骨折（54.0/1000人-年），而对照组发生39例髋部骨折（78.8/1000人-年）。调整危险因素后，干预组髋部骨折的危险比为0.56（95%CI，0.31-1.03; p = 0.06）。在亚组分析中，髋关节保护器对有跌倒史的居民预防髋关节骨折更有效（n = 202; HR，0.375; 95%CI，0.14-0.98; p = 0.05）和BMI a千分之一货币符号欧元千分之19.0（n = 206; HR，0.37; 95%CI，0.14-0.95; p = 0.04）。髋部护具使用的总体依从性为79.7%，髋部护具可降低有跌倒史和低BMI的老年女性髋部骨折的风险。
In our cluster randomised controlled trial for efficacy of hip protector with 672 ambulatory elderly women, a hip protector was more effective for prevention of hip fractures in residents with fall history (n = 202; hazard ratio (HR), 0.375; 95%CI, 0.14-0.98; p = 0.05) and body-mass index (BMI) a parts per thousand currency signaEuro parts per thousand 19.0 (n = 206; HR, 0.37; 95%CI, 0.14-0.95; p = 0.04) by a Cox proportional hazards regression model.Hip fractures result from both osteoporosis and falling. A potentially cost-effective method of preventing hip fractures involves the use of hip protectors but recent studies have revealed the uncertain effectiveness of hip protectors even in institutional settings.This study was a cluster randomised controlled trial with nursing homes. We randomly assigned 76 homes with 672 ambulatory but frail elderly women. Several risk factors were assessed at baseline and incorporated into a Cox proportional hazards regression model. UMIN Clinical Trials Registry number is UMIN000000467. Research period was between January 2004 and March 2006.In the intervention group, 19 hip fractures occurred (54.0/1,000 person-years), whereas 39 hip fractures occurred in the control group (78.8/1,000 person-years). Hazard ratio of hip fracture in the intervention group was 0.56 (95%CI, 0.31-1.03; p = 0.06) after adjusting for risk factors. In subgroup analysis, hip protectors were more effective for prevention of hip fractures in residents with fall history (n = 202; HR, 0.375; 95%CI, 0.14-0.98; p = 0.05) and BMI a parts per thousand currency signaEuro parts per thousand 19.0 (n = 206; HR, 0.37; 95%CI, 0.14-0.95; p = 0.04). Overall compliance with use of hip protectors was 79.7%.Risk of hip fracture can be reduced by hip protectors among elderly women with fall history and low BMI.