Cauley J A, Thompson D E, Ensrud K C, Scott J C, Black D
University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, PA 15261, USA.
Osteoporos Int. 2000;11(7):556-61. doi: 10.1007/s001980070075.
To examine the risk of mortality following all clinical fractures, we followed 6459 women age 55-81 years participating in the Fracture Intervention Trial for an average of 3.8 years. All fractures and deaths were confirmed by medical record or death certificate. Clinical fractures were fractures that came to medical attention. Fracture status was used as a time-dependent covariate in proportional hazards models. The 907 women who experienced a fracture were older, had lower bone mineral density and were more likely to report a positive fracture history. A total of 122 women died over the course of the study with 23 of these deaths occurring after a clinical fracture. The age-adjusted relative risk (95% confidence intervals) of dying following a clinical fracture was 2.15 (1.36, 3.42). This primarily reflected the higher mortality following a hip fracture, 6.68 (3.08, 14.52); and clinical vertebral fracture, 8.64 (4.45, 16.74). Results were similar after adjusting for treatment assignment, health status and specific common comorbidities. There was no increase in mortality following a forearm or other fracture (non-hip, non-wrist, nonvertebral fracture). In conclusion, clinical vertebral fractures and hip fractures are associated with a substantial increase in mortality among a group of relatively healthy older women.
为了研究所有临床骨折后的死亡风险，我们对6459名年龄在55 - 81岁之间参与骨折干预试验的女性进行了平均3.8年的随访。所有骨折和死亡情况均通过病历或死亡证明进行确认。临床骨折是指引起医疗关注的骨折。骨折状态在比例风险模型中用作时间依存性协变量。经历过骨折的907名女性年龄更大，骨密度更低，且更有可能报告有骨折病史。在研究过程中共有122名女性死亡，其中23例死亡发生在临床骨折之后。临床骨折后死亡的年龄调整相对风险（95%置信区间）为2.15（1.36, 3.42）。这主要反映了髋部骨折后的较高死亡率，为6.68（3.08, 14.52）；以及临床椎体骨折后的较高死亡率，为8.64（4.45, 16.74）。在对治疗分配、健康状况和特定常见合并症进行调整后，结果相似。前臂或其他骨折（非髋部、非腕部、非椎体骨折）后死亡率没有增加。总之，临床椎体骨折和髋部骨折与一组相对健康的老年女性的死亡率大幅增加有关。
