Multimorbidity is associated with fragility fractures in women 50 years and older: A nationwide cross-sectional study.
Multimorbidity is associated with fragility fractures in women 50 years and older: A nationwide cross-sectional study.
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DOI：
10.1016/j.bonr.2021.101139
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发表时间：
2021-12
期刊：
影响因子：
2.5
通讯作者：
Rodrigues AM
中科院分区：
文献类型：
--
作者：
Barcelos A;Lopes DG;Canhão H;da Cunha Branco J;Rodrigues AM
多发性骨折是一个世界性的健康问题，尤其是老年患者，他们有更高的脆性骨折风险。目前，对既往脆性骨折患者的多重骨折负担的认识不足。本研究的目的是评估多发性骨折与既往脆性骨折之间的关系，并评估脆性骨折和/或多发性骨折对50岁及以上女性的生活质量和身体功能的影响。对EpiphilosomaPt研究（2011 - 2013）中年龄≥50岁的女性进行了评价，EpiphilosomaPt研究是一项全国性的基于人群的研究。使用半结构式问卷收集关于社会人口统计学、健康相关生活质量、身体功能、脆性骨折和多发性骨折的自我报告数据。多发性疾病定义为2种或2种以上慢性非传染性疾病。使用假设检验对数据进行描述性探索性分析。多元逻辑回归模型用于评估多发性骨折和脆性骨折之间的相关性，线性回归用于生活质量和身体功能结局。估计50岁以上女性脆性骨折的患病率为17.5%。有脆性骨折史的妇女多项骨折的发生率（74.6%）高于无脆性骨折史的妇女。多变量logistic回归分析显示，与有1种或无自我报告的非传染性慢性疾病的女性相比，患有多发性骨折的女性发生脆性骨折的几率更高（调整后的比值比为1.38; 95%置信区间为1.12-1.69）。在有脆性骨折史的女性中，风湿性疾病（62.7%）和高血压（58.6%）是最常见的自我报告的非传染性慢性疾病。脆性骨折和多发性骨折的组合与较低的生活质量和较高的残疾程度相关。50岁及以上多发性骨折的女性发生脆性骨折的几率显著增加。脆性骨折合并多发伤与生活质量呈负相关，与残疾呈正相关。这项研究强调，需要重新设计保健服务，以照顾病人，预防非传染性慢性病和脆性骨折，特别是50岁及以上的妇女，这些疾病可能会增加脆性骨折的风险。
Multimorbidity is a worldwide health problem, especially in elderly patients who have a higher risk of fragility fracture. Currently, there is insufficient knowledge about the burden of multimorbidity in patients with previous fragility fracture. The aim of this study was to evaluate the association between multimorbidity and previous fragility fracture, and to assess the effect of fragility fracture and/or multimorbidity in the perception of quality-of-life and physical function, in women 50 years of age and older. Women aged ≥50 years from the EpiReumaPt study (2011−2013), a nationwide population-based study, were evaluated. Self-reported data regarding sociodemographics, health-related quality of life, physical functioning, fragility fracture, and multimorbidity were collected using a semi-structured questionnaire. Multimorbidity was defined as 2 or more chronic non-communicable diseases. Descriptive exploratory analysis of the data was performed using hypothesis testing. Multiple logistic regression modelling was used to assess the association between multimorbidity and fragility fractures, and linear regression was used for the quality-of-life and physical function outcomes. The estimated prevalence of fragility fracture in women older than 50 years was 17.5%. A higher prevalence of multimorbidity (74.6%) was found in the group of women with previous fragility fracture than in those without previous fragility fracture. Multivariate logistic regression analysis revealed that women with multimorbidity had a higher odds of fragility fracture (adjusted odds ratio, 1.38; 95% confidence interval, 1.12–1.69), compared with women with 1 or no self-reported non-communicable chronic diseases. In women with previous fragility fracture, rheumatic diseases (62.7%) and hypertension (58.6%) were the most frequently self-reported non-communicable chronic diseases. The combination of fragility fracture and multimorbidity was associated with a lower quality of life and higher degree of disability. Women 50 years and older with multimorbidity had a significantly increased odds of fragility fracture. Fragility fracture combined with multimorbidity was negatively associated with quality of life and positively associated with disability. This study emphasizes the need to redesign health services to care for patients to prevent non-communicable chronic diseases and fragility fracture, particularly in women 50 years and older, in whom these diseases are likely to potentiate the risk of fragility fracture.
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4
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