Epidemiology of extremity fractures in the Netherlands
Epidemiology of extremity fractures in the Netherlands
复制标题
DOI：
10.1016/j.injury.2017.04.047
复制
发表时间：
2017-07-01
影响因子：
2.5
通讯作者：
Goslings, J. C.
中科院分区：
文献类型：
--
作者：
Beerekamp, M. S. H.;Keizera, R. J. O. de Muinck;Goslings, J. C.
引言：对四肢骨折流行病学数据的了解与识别高危人群有关。通过分析不同年龄和性别的骨折发病率和治疗模式，我们可以调整未来的政策，采取预防措施，优化卫生保健管理。目前关于四肢骨折及其治疗的流行病学数据很少，过时或针对小范围骨折。本研究的目的是评估2004年至2012年之间肢体骨折的发病率和治疗趋势与性别和年龄的关系。方法：我们使用了年龄≥ 16岁的肢体骨折患者的国家登记处的组合。骨折按照国际疾病分类（ICD）10进行编码，并分配到一个解剖区域。ICD-10编码用于合并登记研究的数据。报告了绝对数量、发生率、在大学医院接受治疗的患者数量和接受手术治疗的患者数量。结果：从2004年到2012年，荷兰16岁以上的人口从13，047，018人增长到13，639，412人，特别是在46岁及以上的高年龄组。四肢骨折的绝对数量从129，188显著增加到176，129（OR 1.308 [1.299-1.318]），前臂和小腿骨折除外。腕部、手/手指、髋/大腿、踝和足/脚趾骨折的发生率显著增加（3-4%）。与66岁及以上的老年组相比，在16至35岁的年轻组中，男性四肢骨折的发生率高于女性。除前臂骨折外，所有的治疗逐渐转向非大学医院。锁骨/肩、前臂、腕和手/手指骨折的手术治疗的相对和绝对数量都增加了。首先，下肢骨折的非手术治疗增加，除了小腿fractional.Conclusion：在研究期间，我们观察到四肢骨折的发病率增加，并转向手术治疗。大学医院的患者数量下降。如果这些趋势继续下去，政策制定者将被建议考虑四肢骨折治疗需求的变化，并积极增加能力和资源。(C)2017爱思唯尔有限公司版权所有
Introduction: Insight in epidemiologic data of extremity fractures is relevant to identify people at risk. By analyzing age-and gender specific fracture incidence and treatment patterns we may adjust future policy, take preventive measures and optimize health care management. Current epidemiologic data on extremity fractures and their treatment are scarce, outdated or aiming at a small spectrum of fractures. The aim of this study was to assess trends in incidence and treatment of extremity fractures between 2004 and 2012 in relation to gender and age.Methods: We used a combination of national registries of patients aged >= 16 years with extremity fractures. Fractures were coded by the International Classification of Diseases (ICD) 10, and allocated to an anatomic region. ICD-10 codes were used for combining the data of the registries. Absolute numbers, incidences, number of patients treated in university hospitals and surgically treated patients were reported. A binary logistic regression was used to calculate trends during the study period.Results: From 2004 to 2012 the Dutch population aged >= 16 years grew from 13,047,018 to 13,639,412 inhabitants, particularly in the higher age groups of 46 years and older. The absolute number of extremity fractures increased significantly from 129,188 to 176,129 (OR 1.308 [1.299-1.318]), except for forearm and lower leg fractures. Incidences increased significantly (3-4%) for wrist, hand/finger, hip/upper leg, ankle and foot/toe fractures. In contrast to the older age categories from 66 years and older, in younger age categories from 16 to 35 years, fractures of the extremities were more frequent in men than in women. Treatments gradually moved towards non-university hospitals for all except forearm fractures. Both relative and absolute numbers increased for surgical treatments of clavicle/shoulder, forearm, wrist and hand/finger fractures. Contrarily, lower extremity fractures showed an increase in non-surgical treatment, except for lower leg fractures.Conclusion: During the study period, we observed an increasing incidence of extremity fractures and a shift towards surgical treatment. Patient numbers in university hospitals declined. If these trends continue, policy makers would be well advised to consider the changing demands in extremity fracture treatment and pro-actively increase capacity and resources. (C) 2017 Elsevier Ltd. All rights reserved.