Survival after hip fracture:: Short- and long-term excess mortality according to age and gender
Survival after hip fracture:: Short- and long-term excess mortality according to age and gender
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DOI：
10.1007/s001980050197
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发表时间：
1999-01-01
影响因子：
4
通讯作者：
Kopjar, B
中科院分区：
文献类型：
--
作者：
Forsén, L;Sogaard, AJ;Kopjar, B
本研究的目的是分析髋部骨折后的超额死亡率，并揭示不同年龄和性别组的超额死亡率是否以及最终何时消失。对 50 岁及以上人群进行了一项基于人群的前瞻性配对队列研究，涉及 1338 名女性和 487 名男性髋部骨折患者，分别有 11086 名和 8141 名对照者。从 1986 年到 1995 年记录了髋部骨折的发生率和死亡率。我们使用 Kaplan-Meier 曲线和以髋部骨折（是/否）作为时间依赖性协变量的扩展 Cox 回归研究了髋部骨折患者与对照组的超额死亡率。无论年龄大小，男性髋部骨折患者在受伤后第一年的死亡率均高于女性，无论是绝对值（分别为 31% 和 17%）还是相对于年龄匹配的对照组。与对照组相比，髋部骨折患者 1 年内死亡的相对风险 (RR)：女性为 3.3（95% 置信区间 (CI) 2.1-5.2），75 岁以下男性为 4.2（95% CI 2.8-6.4）。 85 岁及以上的女性的相应数字为 1.6 (95% CI 1.2-2.0)，男性为 3.1 (95% CI 2.2-4.2)。除 85 岁及以上女性外，所有年龄和性别组的死亡率在髋部骨折后持续多年，尤其是 75 岁以下女性至少持续 5-6 年（RR = 3.2，95% CI 1.9-5.6）。 85 岁及以上女性髋部骨折后的超额死亡率在 3 个月后消失（RR = 1.0，95% CI 0.8-1.1）。因此，当提及髋部骨折后的超额死亡率时，有必要具体说明性别、年龄和受伤后的时间。
The purpose of this study was to analyze the excess mortality after hip fracture and to reveal whether, and eventually when, the excess mortality vanished in different groups of age and gender. A population-based, prospective, matched-pair, cohort study among persons 50 years of age and older was conducted involving 1338 female and 487 male hip fracture patients with 11 086 and 8141 controls respectively. Occurrence of hip fracture and mortality were recorded from 1986 until 1995. We studied the excess mortality of the hip fracture patients versus controls by using Kaplan-Meier curves and extended Cox regression with hip fracture (yes/no) as time-dependent covariate. The male hip fracture patients had higher mortality than the women the first year after the injury, irrespective of age, both in absolute terms (31% and 17% respectively) and relative to their age-matched controls. The relative risk (RR) of dying within 1 year for hip fracture patients versus controls was 3.3 (95% confidence interval (CI) 2.1-5.2) for women and 4.2 (95% CI 2.8-6.4) for men below 75 years of age. The corresponding figures for persons 85 years and older were 1.6 (95% CI 1.2-2.0) for women and 3.1 (95% CI 2.2-4.2) for men. All groups of age and gender, except women 85 years and older, had a large and significant excess mortality lasting for many years after the hip fracture - at least 5-6 years for women below 75 years of age (RR = 3.2, 95% CI 1.9-5.6). The excess mortality after hip fracture for women 85 years and older had vanished after 3 months (RR = 1.0, 95% CI 0.8-1.1). When referring to the excess mortality after hip fracture it is therefore necessary to specify sex, age and time since injury.