Dementia predicted one-year mortality for patients with first hip fracture A POPULATION-BASED STUDY
Dementia predicted one-year mortality for patients with first hip fracture A POPULATION-BASED STUDY
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DOI：
10.1302/0301-620x.100b9.bjj-2017-1342.r1
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发表时间：
2018-09-01
影响因子：
4.6
通讯作者：
Shen, D-L
中科院分区：
文献类型：
--
作者：
Chiu, H-C;Chen, C-M;Shen, D-L
目的：我们旨在确定痴呆症和帕金森病对亚洲老年患者髋部骨折术后1个月、3个月和12个月死亡率的影响。我们使用Cox回归来估计与痴呆、帕金森病或两者相关的死亡风险，并对人口统计学、临床、治疗和提供者因素进行调整。结果6626例髋部骨折患者中，10.20%合并痴呆，5.60%合并帕金森病，2.67%合并痴呆和帕金森病。相应的1年死亡率分别为15.53%、11.59%和15.82%，而无神经系统疾病者为9.22%。痴呆患者一年死亡率调整后的风险比为1.45(95%可信区间（CI） 1.17 - 1.79)，痴呆和帕金森病患者一年死亡率调整后的风险比为1.57 （95% CI 1.07 - 2.30）。单独的帕金森病与死亡没有明显的关联。年龄、男性性别和合并症也与较高的死亡风险相关。结论痴呆伴或不伴帕金森病是髋部骨折术后死亡率的独立预测因子。年龄、男性性别和合并症也会增加死亡风险。帕金森氏症本身没有明显的影响
AimsWe aimed to determine the effect of dementia and Parkinson's disease on one, three and 12-month mortality following surgery for fracture of the hip in elderly patients from an Asian population.Patients and MethodsUsing a random sample of patients taken from the Taiwan National Health Insurance Research Database, this retrospective cohort study analyzed the data on 6626 elderly patients who sustained a fracture of the hip between 1997 and 2012 who had ICD-9 codes within the general range of hip fracture (820.xx). We used Cox regression to estimate the risk of death associated with dementia, Parkinson's disease or both, adjusting for demographic, clinical, treatment, and provider factors.ResultsAmong 6626 hip fracture patients, 10.20% had dementia alone, 5.60% had Parkinson's disease alone, and 2.67% had both. Corresponding one-year mortality rates were 15.53%, 11.59%, and 15.82%, compared with 9.22% for those without neurological illness. Adjusted hazard ratio for one-year mortality was 1.45 (95% confidence intervals (CI) 1.17 to 1.79) for those with dementia, and 1.57 (95% CI 1.07 to 2.30) with both dementia and Parkinson's disease versus patients with neither. There was no significant association with death for Parkinson's disease alone. Age, male gender and comorbidities were also associated with a higher risk of mortality.ConclusionDementia, with or without Parkinson's disease, is an independent predictor of mortality following surgery for fractures of the hip. Age, male gender and comorbidities also increase the risk of death. Parkinson's disease alone has no significant effect