Femoral neck and intertrochanteric fractures have different risk factors: A prospective study
Femoral neck and intertrochanteric fractures have different risk factors: A prospective study
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DOI：
10.1007/s001980070022
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发表时间：
2000-01-01
影响因子：
4
通讯作者：
Stone, K
中科院分区：
文献类型：
--
作者：
Fox, KM;Cummings, SR;Stone, K
本研究的目的是确定两种类型的髋部骨折，股骨颈和转子间，是否有相似的危险因素。对美国四个地区的社区居住老年妇女进行了前瞻性队列研究：巴尔的摩，MD;匹兹堡，PA;明尼阿波利斯，MN和波特兰，OR。参与者为9704名65岁及以上的白人女性，其中279人股骨颈骨折，222人股骨近端转子区骨折。预测因素包括跟骨和股骨近端的骨量、人体测量学、骨折史（家庭和个人）、药物使用、功能状态、体力活动和视觉功能。主要的结局指标是平均8年随访期间发生的股骨颈和转子间骨折。在多变量比例风险模型中，几个危险因素增加了两种类型髋部骨折的风险：包括股骨颈骨密度和功能困难增加。在直接比较两种类型髋部骨折危险因素的风险回归模型中，跟骨骨矿物质密度（BMD）预测股骨颈骨折的能力强于股骨转子间骨折（OR = 1.16; 95%CI = 1.02-1.31）。类固醇的使用和受损的功能状态也预测股骨颈骨折，而不是转子间骨折。健康状况差（OR = 0.74; 95%CI = 0.55-1.00）对股骨粗隆间骨折的预测作用强于股骨颈骨折。我们的结论是，股骨颈骨折在很大程度上预测骨密度和功能差的能力，而年龄和健康状况差易患股骨粗隆间骨折。
The aim of this study was to determine whether both types of hip fracture, femoral neck and intertrochanteric, have similar risk factors. A prospective cohort study was carried out on community-dwelling elderly women in four areas of the United States: Baltimore, MD; Pittsburgh, PA; Minneapolis, MN and Portland, OR. The participants were 9704 Caucasian women, 65 years and older, of whom 279 had fractured their femoral neck and 222 had fractured their trochanteric region of the proximal femur. The predictors used were the bone mass of the calcaneus and proximal femur, anthropometry, history of fracture (family and personal), medication use, functional status, physical activity and visual function. The main outcome measures were femoral neck and intertrochanteric fractures occurring during an average of 8 years of follow-up. In multivariate proportional hazards models, several risk factors increased the risk of both types of hip fracture: including femoral neck bone density and increased functional difficulty. In hazard regression models that directly compared risk factors for the two types of hip fracture, calcaneal bone mineral density (BMD) predicted femoral neck fractures more strongly than intertrochanteric fractures (OR = 1.16; 95% CI = 1.02-1.31). Steroid use and impaired functional status also predicted femoral neck fractures instead of intertrochanteric fractures. Poor health status (OR = 0.74; 95% CI = 0.55-1.00) predicted intertrochanteric fractures more strongly than femoral neck fractures. We conclude that femoral neck fractures are largely predicted by BMD and poor functional ability while aging and poor health status predispose to intertrochanteric fractures.