Survival after hip fracture
Survival after hip fracture
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DOI：
10.1007/s00198-005-2024-z
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发表时间：
2005-12-01
影响因子：
4
通讯作者：
Baron, JA
中科院分区：
文献类型：
--
作者：
Farahmand, BY;Michaëlsson, K;Baron, JA
尽管已知髋部骨折后总体死亡率会增加，但髋部骨折危险因素对后续死亡率和死因的影响尚未得到充分研究。本研究的目的是确定女性髋部骨折后的生存情况并评估合并症对死亡率的影响。我们在瑞典 50-81 岁女性中确定了一组完整的基于人群的 2,245 例髋部骨折病例和 4,035 例随机选择的基于人群的对照，并通过瑞典国家住院患者和死因登记册对这些受试者进行了平均 5 年的跟踪。通过与出院数据的联系和邮寄调查问卷获得了与髋部骨折相关的因素的信息。我们使用生存曲线和比例风险回归模型研究了髋部骨折患者与对照组相比的超额死亡率。在随访期间，896 名髋部骨折患者 (40%) 和 516 名对照者 (13%) 死亡。根据年龄和既往因严重疾病住院情况进行调整后，死亡的相对风险 (RR) 为 2.3 (95% CI 2.0-2.5)。尽管最高的死亡风险发生在骨折后的前 6 个月，但与对照组相比，骨折的 RR 增加了至少 6 年。无论是有合并症证据还是无合并症证据的患者，死亡率均明显增加。髋部骨折患者的死亡风险显着增加，并且这种风险在骨折后持续至少 6 年。相对超额死亡率与合并症和已知的髋部骨折危险因素无关。
Although it is known that overall mortality is increased after hip fracture, the influence of hip fracture risk factors on the subsequent mortality and cause of death has not been well studied. The objective of this study was to establish the survival after hip fracture in women and to assess the impact of comorbidity on mortality. We identified a complete population-based set of 2,245 incident hip fracture cases and 4,035 randomly selected population-based controls among women 50-81 years old in Sweden and followed these subjects for an average of 5 years through the Swedish National Inpatient and Cause-of-Death Registers. Information on factors related to hip fracture was obtained through linkage to hospital discharge data and through a mailed questionnaire. We studied excess mortality of hip fracture patients compared to controls using survival curves and proportional hazard regression models. During follow-up, 896 hip fracture patients (40%) and 516 (13%) controls died. The relative risk (RR) of death, adjusted for age and previous hospitalization for serious disease, was 2.3 (95% CI 2.0-2.5). Although the highest mortality risks were in the 1st 6 months post-fracture, RRs for fractures versus controls were increased for at least 6 years. Increased mortality was apparent both in those with evidence of comorbidity and those without. Hip fracture patients have a substantially increased risk of death that persists for at least 6 years post-fracture. The relative excess mortality is independent of comorbidity and known hip fracture risk factors.