Fierens J, Broos P L O
Department of Surgery, UZ Gasthuisberg, Leuven, Belgium.
Acta Chir Belg. 2006 Jul-Aug;106(4):393-6. doi: 10.1080/00015458.2006.11679913.
As the world population ages, the prevalence of osteoporosis and the incidence of hip fractures will increase dramatically, being responsible for an increase of the health expenditure. On the other hand, there is the inescapable fact of scarcity creating the necessity of making difficult choices with regard to the allocation of human resources. So the question remains: should we carry on investing an important part of our health expenditure for the treatment of hip fractures in elderly people? To answer this statement, we compared 384 hip fracture patients of 70 years and older treated in our department between 1978 and 1983 with 1102 patients treated between 1998 and 2003. Both groups had a prospective follow-up of at least one year. There were no statistically significant differences: mortality rate 24% vs. 23%; good functional outcome 82% vs. 73%; and home going rate 60% vs. 66%. The factors influencing these results were studied. So we can conclude: The number of hip fractures treated nowadays has increased compared with twenty years ago; There is no significant improvement in mortality, nor in quality of life; Age is not a contraindication for hip fracture surgery.
随着世界人口老龄化，骨质疏松症的患病率和髋部骨折的发生率将急剧上升，导致医疗支出增加。另一方面，不可避免的事实是资源稀缺，这就需要在人力资源分配方面做出艰难抉择。所以问题依然存在：我们是否应该继续将大量医疗支出投入到老年髋部骨折的治疗上？为了回答这个问题，我们将1978年至1983年在我科接受治疗的384例70岁及以上髋部骨折患者与1998年至2003年治疗的1102例患者进行了比较。两组均进行了至少一年的前瞻性随访。结果无统计学显著差异：死亡率分别为24%和23%；良好功能结局分别为82%和73%；回家率分别为60%和66%。我们研究了影响这些结果的因素。因此我们可以得出结论：与二十年前相比，如今治疗的髋部骨折数量有所增加；死亡率和生活质量均无显著改善；年龄不是髋部骨折手术的禁忌证。
