Magaziner Jay, Fredman Lisa, Hawkes William, Hebel J Richard, Zimmerman Sheryl, Orwig Denise L, Wehren Lois
Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Am J Epidemiol. 2003 Jun 1;157(11):1023-31. doi: 10.1093/aje/kwg081.
Disability attributable to hip fracture regarding activities of daily living was evaluated by comparing 594 hip fracture patients entering eight hospitals in Baltimore, Maryland, in 1990-1991 with community-dwelling aged from the Established Populations for Epidemiologic Studies of the Elderly (EPESE) cohort matched on age, sex, and walking ability. Subjects were assessed at baseline (prefracture report for patients), 12 months, and 24 months. At baseline, 26% of both groups had walking disability, 12-14% had transferring disability, and 6-8% evidenced grooming disability. At 12 and 24 months, about 50% of hip fracture patients were walking disabled compared with 21-29% of EPESE respondents after the authors controlled for age, sex, comorbidities, and functional status (excess disability attributable to hip fracture, i.e., attributable disability, of 26 additional cases of disability per 100 persons in the hip fracture cohort during follow-up). Likewise, hip fracture patients experienced more disability regarding transferring (38-39% vs. 10-18%; attributable disability, approximately 22 cases per 100 persons) and grooming (17-19% vs. 7-15%; attributable disability, approximately six cases per 100 persons). Thus, results showed that hip fracture patients had substantially more activities of daily living disability than that explained by aging over 24 months.
通过将1990 - 1991年进入马里兰州巴尔的摩市八家医院的594名髋部骨折患者与来自老年流行病学研究既定人群（EPESE）队列、在年龄、性别和行走能力方面相匹配的社区老年人进行比较，评估了与日常生活活动相关的髋部骨折所致残疾情况。在基线（患者骨折前报告）、12个月和24个月时对受试者进行评估。在基线时，两组中26%的人有行走残疾，12 - 14%的人有转移残疾，6 - 8%的人有修饰残疾。在12个月和24个月时，在作者控制了年龄、性别、合并症和功能状态后，约50%的髋部骨折患者存在行走残疾，而EPESE受访者中这一比例为21 - 29%（髋部骨折队列在随访期间每100人中有26例额外的残疾归因于髋部骨折，即归因残疾）。同样，髋部骨折患者在转移方面经历了更多残疾（38 - 39%对10 - 18%；归因残疾，每100人约22例）和修饰方面（17 - 19%对7 - 15%；归因残疾，每100人约6例）。因此，结果表明，髋部骨折患者在日常生活活动方面的残疾比24个月衰老所解释的要多得多。
