Mortality in British hip fracture patients, 2000-2010: A population-based retrospective cohort study
Mortality in British hip fracture patients, 2000-2010: A population-based retrospective cohort study
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DOI：
10.1016/j.bone.2014.06.011
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发表时间：
2014-09-01
期刊：
影响因子：
4.1
通讯作者：
de Vries, Frank
中科院分区：
文献类型：
--
作者：
Klop, Corinne;Welsing, Paco M. J.;de Vries, Frank
背景：关于髋部骨折后死亡率近期趋势的数据很少。因此，目的是检查髋部骨折后全因和原因特异性死亡率的长期趋势，并将其与2000年至2010年的一般人群进行比较。方法：在英国临床实践研究数据链中进行基于人群的队列研究，并与57.7%患者的死亡原因数据相关联。首次髋骨骨折患者（n = 31，495）按年龄、性别、索引日期和实践与最多4个对照组相匹配。随访所有受试者的死亡情况，计算生活方式、疾病和用药史调整后的风险比（HRs）。结果：髋部骨折后一年全因死亡率自2009年起下降，与2009年前相比下降了14%（22.3%至20.5%，调整后HR 0.86，95%CI：0.81-0.92）。男性（>= 75岁）和女性（>= 85岁）的比例都有所下降。髋部骨折后死亡率下降的重要因素是女性的呼吸道感染和男性的恶性疾病。然而，与对照组相比，一年全因死亡率在十年内保持不变，男性和女性的风险分别增加了3.5倍和2.4倍。没有显着的变化，观察到一年的原因特异性mortality for both genders.Conclusions的相对风险：髋部骨折后一年的死亡率下降，在过去的十年中，在英国然而，髋部骨折患者和一般人群之间的一年死亡率的差异仍然没有改变。这些观察结果强调需要继续实施基于证据的标准，以获得良好的髋部骨折护理。(C)2014 Elsevier Inc. All rights reserved.
Background: Data on recent trends in mortality after hip fracture are scarce. Aims were therefore to examine secular trends in all-cause and cause-specific mortality post hip fracture and to compare this to the general population from 2000 to 2010.Methods: Population-based cohort study within the United Kingdom Clinical Practice Research Datalink and linked to cause of death data for 57.7% of patients. Patients with a first hip fracture (n = 31,495) were matched to up to four controls by age, sex, index date, and practice. All subjects were followed for death, and lifestyle, disease and medication history adjusted hazard ratios (HRs) were calculated.Results: One-year all-cause mortality after hip fracture declined from 2009 and was 14% lower after, compared with before 2009 (22.3% to 20.5%, adj. HR 0.86, 95% Cl: 0.81-0.92). The decline was observed for males (>= 75 years) and females (>= 85 years). Significant contributors to the decline in mortality post hip fracture were respiratory infections in females as were malignant diseases in males. However, one-year all-cause mortality remained unaltered over the decade when compared to controls with a 3.5-fold and 2.4-fold increased risk in males and females respectively. No significant changes were observed in the relative risks for one-year cause-specific mortality for both genders.Conclusions: One-year mortality after hip fracture has declined over the last decade in the UK However, the difference in one-year mortality between hip fracture patients and the general population remained unaltered. These observations highlight the need for the continued implementation of evidence-based standards for good hip fracture care. (C) 2014 Elsevier Inc. All rights reserved.