The risk of fracture following hospitalization in older women and men
The risk of fracture following hospitalization in older women and men
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DOI：
10.1001/archinte.168.15.1671
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发表时间：
2008-08-11
影响因子：
--
通讯作者：
Cummings, Steven R.
中科院分区：
文献类型：
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作者：
Gardner, Rebekah L.;Harris, Fran;Cummings, Steven R.
背景资料：住院治疗可能会导致骨质流失和身体功能下降;然而，住院治疗后骨折的风险尚不清楚。方法：一项前瞻性研究的队列3075白色和黑人妇女和男子，年龄在70至79岁，从1997年至1998年招募2个社区。住院和骨折事件由对患者分组不知情的研究者通过医疗记录进行验证。住院时间，住院次数，骨折风险之间的相关性进行了分析调整年龄，种族，性别，和其他潜在的混杂factors.Results：在随访期间，平均持续时间为6.6年，2030（66%）的3075名参与者入院治疗，809（26%）入院3次或以上; 285例发生骨折，包括74例髋部骨折。在调整年龄、种族和性别后，那些住院治疗的患者骨折风险增加2倍（风险比[HR]，2.01; 95%置信区间[CI]，1.57-2.57），包括髋部骨折风险增加（HR，2.15; 95% CI，1.32-3.50）。那些在随访期间住院两次的人髋部骨折的风险增加了2.42倍（95%CI，1.16-5.05），并且3次或3次以上住院表明髋部骨折的相对危险度增加3.66倍（95% CI，1.78-7.53）。住院治疗，特别是多次入院，在老年人中非常常见，并且与髋部和其他类型骨折的风险增加密切相关。住院治疗提供了采取措施降低骨折风险的机会。
Background: Hospitalization may cause bone loss and decrease physical function; however, the risk of fracture following hospitalization is not known.Methods: A prospective study of a cohort of 3075 white and black women and men, aged 70 to 79 years, recruited from 2 communities from 1997 to 1998. Incident hospitalizations and fractures were validated by medical records by investigators blinded to patient groupings. Analyses of the association between hospitalization, length of stay, number of admissions, and risk of fracture were adjusted for age, race, sex, and other potential confounding factors.Results: During follow-up with a mean duration of 6.6 years, 2030 (66%) of the 3075 participants were admitted to a hospital and 809 (26%) were admitted 3 or more times; 285 experienced a fracture, including 74 hip fractures. After adjusting for age, race, and sex, those who had any hospitalization had a 2-fold increased risk of fracture (hazard ratio [HR], 2.01; 95% confidence interval [CI], 1.57-2.57), including an increased risk of hip fracture (HR, 2.15; 95% CI, 1.32-3.50). Those who were hospitalized twice during the follow-up period had a 2.42-fold increased risk of hip fracture (95% CI, 1.16-5.05), and 3 or more hospital stays indicated a 3.66-fold increased relative hazard for hip fracture (95% CI, 1.78-7.53).Conclusions: Hospitalizations, particularly multiple admissions, are very common in elderly individuals and are strongly associated with an increased risk of hip and other types of fracture. Hospitalizations present opportunities to take measures to reduce the risk of fractures.