Mortality after all major types of osteoporotic fracture in men and women: an observational study
Mortality after all major types of osteoporotic fracture in men and women: an observational study
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DOI：
10.1016/s0140-6736(98)09075-8
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发表时间：
1999-03-13
期刊：
影响因子：
168.9
通讯作者：
Eisman, JA
中科院分区：
文献类型：
--
作者：
Center, JR;Nguyen, TV;Eisman, JA
背景髋部骨折后死亡率在女性中增加，在男性中更是如此。然而，对其他骨折后的死亡率知之甚少。我们调查的死亡率与所有骨折类型的老年妇女和mes.Methods我们做了5年的前瞻性队列研究，在半城市的杜博，澳大利亚，所有居民年龄在60岁及以上（2413名妇女和1898名男子）。1989年至1994年间发生的低创伤性骨质疏松性骨折，经X线片和个人访谈证实，被分类为股骨近端骨折、椎骨骨折和其他大、小骨折。我们计算了标准化死亡率从死亡证明的人骨折相比，杜博population.Findings 356名妇女和137名男子低创伤骨折。在女性和男性中，死亡率在所有重大骨折后的第一年增加。在女性中，年龄标准化死亡率为股骨近端2.18（95%CI 2.03-2.32），椎骨1.66（1.51-1.80），其他主要骨折1.92（1.70-2.14），轻微骨折0.75（0.66-0.84）。在男性中，股骨近端的这些比率为3.17（2.90-3.44），椎骨为2.38（2.17-2.59），其他主要骨折为2.22（1.91-2.52），轻微骨折为1.45（1.25-1.65）。在所有年龄组中，都有过多的死亡（不包括女性的轻微骨折）。解释所有重大骨折都与死亡率增加有关，尤其是男性。年轻年龄组潜在寿命年数的损失表明，骨折的预防策略不应以牺牲年轻女性和男性为代价而集中于老年患者。
Background Mortality increases after hip fractures in women and more so in men. Little is known, however, about mortality after other fractures. We investigated the mortality associated with all fracture types in elderly women and men.Methods We did a 5-year prospective cohort study in the semi-urban city of Dubbo, Australia, of all residents aged 60 years and older (2413 women and 1898 men). Low-trauma osteoporotic fractures that occurred between 1989 and 1994, confirmed by radiography and personal interview, were classified as proximal femur, vertebral, and groupings of other major and minor fractures. We calculated standardised mortality rates from death certificates for people with fractures compared with the Dubbo population.Findings 356 women and 137 men had low-trauma fractures. In women and men, mortality was increased in the first year after all major fractures. In women, age-standardised mortality ratios were 2.18(95% CI 2.03-2.32) for proximal femur, 1.66 (1.51-1.80) for vertebral, 1.92 (1.70-2.14) for other major, and 0.75 (0.66-0.84) for minor fractures. In men, these ratios were 3.17 (2.90-3.44) for proximal femur, 2.38 (2.17-2.59) for vertebral, 2.22 (1.91-2.52) for other major, and 1.45 (1.25-1.65) for minor fractures. There were excess deaths (excluding minor fractures in women) in all age-groups.Interpretation All major fractures were associated with increased mortality, especially in men. The loss of potential years of life in the younger age-group shows that preventative strategies for fracture should not focus on older patients at the expense of younger women and of men.