Dolinak David
Cuyahoga County Coroner's Office, Cleveland, OH, USA.
Am J Forensic Med Pathol. 2008 Jun;29(2):99-105. doi: 10.1097/PAF.0b013e31817440ac.
The elderly are more prone to sustain fractures with low force injury because they have an increased incidence of falls, and because their bones are often more fragile secondary to osteoporosis and other conditions. Cases with fracture are routinely reported to medical examiner and coroner offices because fracture reflects traumatic injury. If a fracture is judged to be a significant factor in a person's death, then the manner of death must reflect how the injury was sustained, which is "accidental" in most of these cases. Often times the best information on the significance of a fracture is obtained from the deceased's physician, nurse, family, or close acquaintance. However, this valuable clinical information is not always available. When this is the situation, it would be helpful to know generally what fractures are likely to be associated with increased mortality, and for how long any excess mortality might be expected to persist. With this in mind, a search of the literature was performed to clarify clinically which fractures in the elderly population were associated with excess mortality and the duration that any excess mortality tended to persist.
老年人更容易因低暴力损伤而发生骨折,这是因为他们跌倒的发生率增加,而且由于骨质疏松和其他疾病,他们的骨骼通常更脆弱。骨折病例通常会报告给法医和验尸官办公室,因为骨折反映了创伤性损伤。如果骨折被判定为导致一个人死亡的重要因素,那么死亡方式必须反映出损伤是如何发生的,在大多数此类情况下为“意外”。通常,关于骨折重要性的最佳信息来自死者的医生、护士、家人或密友。然而,这些宝贵的临床信息并非总是可得。在这种情况下,了解哪些骨折可能与死亡率增加相关,以及任何额外的死亡率可能会持续多长时间会有所帮助。考虑到这一点,我们进行了文献检索,以明确临床上老年人群中的哪些骨折与额外死亡率相关,以及任何额外死亡率倾向于持续的时间。