Hawkes William G, Wehren Lois, Orwig Denise, Hebel J Richard, Magaziner Jay
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Division of Gerontology, 660 W. Redwood Street, Suite 200, Baltimore, MD 21201, USA.
J Gerontol A Biol Sci Med Sci. 2006 May;61(5):495-9. doi: 10.1093/gerona/61.5.495.
Hip fracture is a significant health problem for men and women; between 25 and 30 percent of all hip fractures are sustained by men. Relatively little is known about gender differences in functional outcomes after hip fracture. The purpose of the current study is to compare post-hip fracture functional recovery of men and women.
A sample of 674 patients age 65 or older were recruited as part of the Baltimore Hip Studies and were followed longitudinally for 1 year following fracture. Information on prefracture status and hospital course of treatment was collected as well as functional data at baseline, 2, 6, and 12 months postfracture. Data were analyzed longitudinally using Generalized Estimating Equations (GEEs).
Men in the study were generally younger and suffered greater comorbidity at time of fracture. Men further suffered higher mortality in the year following fracture. Among survivors, little difference between men and women was seen in patterns of recovery of function following fracture.
Hip fracture is not a problem affecting just women. Recovery following fracture for men is probably no better than that for women, even after mortality differentially eliminates the frailest male participants. However, psychosocial factors, greater comorbidity, and higher rates of certain complications among men may require adjustments to interventions designed to restore function. Further research into the consequences of hip fracture for men and women is needed.
髋部骨折对男性和女性来说都是一个重大的健康问题;所有髋部骨折中,25%至30%由男性遭受。关于髋部骨折后功能结局的性别差异,人们了解相对较少。本研究的目的是比较男性和女性髋部骨折后的功能恢复情况。
作为巴尔的摩髋部研究的一部分,招募了674名65岁及以上的患者样本,并在骨折后对他们进行了为期1年的纵向随访。收集了骨折前状态和住院治疗过程的信息,以及骨折后基线、2个月、6个月和12个月时的功能数据。使用广义估计方程(GEEs)对数据进行纵向分析。
该研究中的男性通常更年轻,骨折时合并症更多。男性在骨折后的一年内死亡率也更高。在幸存者中,骨折后男女在功能恢复模式上差异不大。
髋部骨折并非仅影响女性的问题。男性骨折后的恢复情况可能并不比女性好,即使死亡率差异消除了最脆弱的男性参与者。然而,男性的心理社会因素、更多的合并症以及某些并发症的更高发生率可能需要对旨在恢复功能的干预措施进行调整。需要对髋部骨折对男性和女性的影响进行进一步研究。