Shao Chung-Jung, Hsieh Yu-Hsiang, Tsai Ching-Hui, Lai Kuo-An
Department of Orthopedics, National Cheng Kung University Hospital, Tainan, Taiwan.
Bone. 2009 Jan;44(1):125-9. doi: 10.1016/j.bone.2008.09.004. Epub 2008 Sep 20.
To investigate the recent longitudinal trend of hip fractures (including cervical and trochanteric fractures) in Taiwan's elderly population (> or =65 years), a nationwide descriptive epidemiological study was conducted using the database of the Bureau of National Health Insurance from 1996 through 2002. Frequencies and incidences of hip fracture by gender, fracture site, and age group were estimated, and the 7-year incidence trend was further evaluated. The results showed that a total of 75,482 hip fractures occurred during the study period with an incidence rate of 57.54 per 10,000 per year. Overall incidence significantly increased by 30% (p<0.0001), from 49.56 to 64.37 per 10,000 per year during the 7-year study period. The increase in rates was greater in males (36%) than in females (22%). The average female-to-male ratio was 1.76, lower than those in many countries. In females, the annual incidence of cervical fracture was higher than that of trochanteric fractures throughout the 7 years, while the incidence of trochanteric fractures was higher than cervical fractures each year in males (p<0.0001). The average annual incidence of patients older than 85 years was 9.9 times higher than that of aged 65 to 69 years in females and 7.9 times in males. Development and implementation of public health strategies for hip fractures should more focus on these subgroups in Taiwan's rapidly aging society.
为调查台湾老年人群(≥65岁)髋部骨折(包括颈椎骨折和转子间骨折)近期的纵向趋势,利用1996年至2002年全民健康保险局的数据库进行了一项全国性描述性流行病学研究。估计了按性别、骨折部位和年龄组划分的髋部骨折频率和发病率,并进一步评估了7年发病率趋势。结果显示,研究期间共发生75482例髋部骨折,发病率为每年每10000人中有57.54例。在7年的研究期间,总体发病率显著上升了30%(p<0.0001),从每年每10000人中有49.56例升至64.37例。男性发病率的上升幅度(36%)大于女性(22%)。女性与男性的平均比例为1.76,低于许多国家。在女性中,7年间颈椎骨折的年发病率高于转子间骨折,而在男性中,每年转子间骨折的发病率高于颈椎骨折(p<0.0001)。85岁以上患者的平均年发病率在女性中比65至69岁的患者高9.9倍,在男性中高7.9倍。在台湾快速老龄化的社会中,髋部骨折公共卫生策略的制定和实施应更多地关注这些亚组人群。