Epidemiology of hip fractures: Implications of the exponential increase with age
Epidemiology of hip fractures: Implications of the exponential increase with age
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DOI：
10.1016/8756-3282(95)00492-0
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发表时间：
1996-03-01
期刊：
影响因子：
4.1
通讯作者：
Melton, LJ
中科院分区：
文献类型：
--
作者：
Melton, LJ
在与骨质疏松症相关的骨折中，髋部骨折在死亡、功能依赖和社会成本方面最为重要。减少这些不良结局取决于预防髋部骨折，髋部骨折是由跌倒在生物力学受损的股骨近端引起的。骨骼强度取决于骨量及其结构排列，而股骨近端的创伤负荷则取决于跌倒的方向和其他因素。这些潜在机制中的一种或几种解释了已确定的髋部骨折的各种风险因素，包括女性的发病率高于男性，白色人群的发病率高于非白色人群。然而，随着年龄的增长，髋部骨折的发病率呈指数级增长，这表明各种因素的复杂相互作用决定了每个人骨折的风险。问题的多因素性质表明，髋部骨折将难以预防，即使骨折及其相关费用随着老年人数量的增加而继续上升。然而，欧洲和北美高风险人群中髋部骨折率的变异性反映了其他强有力的风险因素的存在，如果确定这些因素，可能会为更有效的干预措施提供基础。
Of the fractures linked with osteoporosis, hip fractures are most important in terms of death, functional dependence, and social cost. Reduction of these adverse outcomes depends on preventing hip fractures, which are caused by falling on a biomechanically compromised proximal femur. Skeletal strength depends on the amount of bone and its structural arrangement, whereas the traumatic load on the proximal femur is dictated by the orientation of the fall and other factors. One or several of these underlying mechanisms account for the various risk factors that have been identified for hip fracture, including greater incidence rates among women than men and among white than nonwhite populations. However, the exponentially increasing incidence of hip fractures with age indicates that a complex interplay of factors determines the risk of fracture in each person. The multifactorial nature of the problem suggests that hip fractures will be difficult to prevent even as the fractures and their associated costs continue to rise with the increased number of older people. However, the variability of hip fracture rates within high risk populations in Europe and North America reflects the existence of other powerful risk factors that, if identified, might provide the basis for more effective interventions.