Factors: associated with mortality after hip fracture
Factors: associated with mortality after hip fracture
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DOI：
10.1007/s001980050285
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发表时间：
2000-01-01
影响因子：
4
通讯作者：
Pedersen, JI
中科院分区：
文献类型：
--
作者：
Meyer, HE;Tverdal, A;Pedersen, JI
众所周知，髋部骨折后死亡率过高，这可能仅限于健康状况下降的髋部骨折患者亚组。我们研究了248名髋部骨折患者和248名对照者的危险因素与死亡之间的关系，这些患者最初参加了一项基于人群的病例对照研究。该队列的总死亡率随访3年半。在髋部骨折患者中，通过精神状态测试的低得分[相对危险度（RR）= 2.3，95%置信区间（CI）1.4-3.7]，报告两种或两种以上选定慢性疾病的髋部骨折患者，（RR = 3.3，95% CI 1.8-6.1），骨折前未在户外行走的髋部骨折患者（RR = 3.2，95% CI 2.0-5.1）和髋部骨折患者的握力分布在下半部（RR = 2.3，95% CI 1.6-3.4），均与对照组比较。相比之下，没有这些危险因素的髋部骨折患者与对照组相比死亡率并没有增加。这项研究表明，其他健康和合适的患者不会增加髋部骨折后的死亡率。死亡率过高的人仅限于精神状态下降、身体健康状况下降和体能低下的人。在治疗和康复期间，应特别注意有此类危险因素的患者。
There is a well-known excess mortality subsequent to hip fracture, which is probably restricted to subgroups of hip fracture patients with reduced health status. We studied the association between risk factors and death in 248 hip fracture patients and 248 controls originally enrolled in a population-based case-control study. This cohort was followed for 3 1/2 years with respect to total mortality. A markedly increased mortality was found in hip fracture patients passing a mental status test at a low score [relative risk (RR) = 2.3, 95% confidence interval (CI) 1.4-3.7], in hip fracture patients reporting two or more selected chronic diseases (RR = 3.3, 95% CI 1.8-6.1), in hip fracture patients not walking outdoors before the fracture (RR = 3.2, 95% CI 2.0-5.1) and in hip fracture patients in the lower half of handgrip strength distribution (RR = 2.3, 95% CI 1.6-3.4), all compared with the control group. In contrast, hip fracture patients without these risk factors did not have increased mortality compared with the control group. This study suggests that otherwise healthy and fit patients do not have increased mortality subsequent to hip fracture. The excess mortality is restricted to persons with reduced mental status, reduced somatic health and low physical ability. Special attention should be paid to patients with such risk factors in the treatment and rehabilitation period.