Department of Orthopaedic and Trauma Surgery, Hairmyres Hospital, East Kilbride, United Kingdom.
Injury. 2009 Jul;40(7):722-6. doi: 10.1016/j.injury.2008.11.004. Epub 2009 May 8.
BACKGROUND: During the first three decades of the 21st century the combination of increasing life expectancy and falling birth rates will result in substantial demographic changes within the population of the United Kingdom. A large increase in the elderly population is likely to have significant effects on the number of patients who sustain a hip fracture. AIM: To predict future changes in hip fracture burden in Scotland. MATERIALS AND METHODS: Data was obtained from the Scottish Hip Fracture Audit database for a 12 month period between April 2004 and March 2005. All orthopaedic units in Scotland participated in the audit during this period. This data was used to calculate the incidence of hip fracture by 5 year age/gender cohorts. Outcome data was analysed in a similar manner. Population prediction data obtained from the Registrar General's Office was then used to predict hip fracture numbers for the year 2031. Two separate prediction models were used. The first model assumed that the age/gender specific incidence of hip fracture observed in 2004 would remain constant. Between 1999 and 2004, a 9.6% decrease in the population incidence of hip fracture was observed. Therefore a second prediction model was used which assumed a continuation in the fall in population incidence of hip fracture between 2004 and 2031. RESULTS: The population aged 50 years and above is predicted to increase 28% by 2031, with the most significant increases occurring in the over 1980s. The number of hip fractures is predicted to rise by 45% to 75% (from 6164 to 8829-10756 cases per annum) requiring an additional 287-474 hospital beds. By 2031 approximately 45% of fractures will occur in those aged 85 years and above, compared to 34% in 2004. Predicted changes in population demographics are highly variable by region and so local planning of resource provision will be essential. CONCLUSION: Changes in population demographics will have significant implications for health care provision for the care of hip fracture patients. An increase in the capacity of acute orthopaedic care and a review of care models will be required to ensure adequate resource provision.
背景：在 21 世纪的头三十年，预期寿命的延长和出生率的下降将导致英国人口结构发生重大变化。老年人口的大量增加可能会对髋部骨折患者的数量产生重大影响。
目的：预测苏格兰髋部骨折负担的未来变化。
材料和方法：数据来自苏格兰髋部骨折审计数据库，该数据库涵盖了 2004 年 4 月至 2005 年 3 月的 12 个月。在此期间，苏格兰所有骨科单位都参与了审计。该数据用于按 5 年年龄/性别队列计算髋部骨折的发病率。以类似的方式分析结果数据。然后使用来自登记总干事办公室的人口预测数据来预测 2031 年的髋部骨折数量。使用了两种单独的预测模型。第一个模型假设 2004 年观察到的年龄/性别特异性髋部骨折发病率保持不变。在 1999 年至 2004 年期间，髋部骨折的人群发病率下降了 9.6%。因此，使用了第二个预测模型，假设 2004 年至 2031 年期间髋部骨折的人群发病率继续下降。
结果：预计到 2031 年，50 岁及以上的人口将增加 28%，其中增幅最大的是 20 世纪 80 年代以后的人口。髋部骨折的数量预计将增加 45%至 75%（从每年 6164 例增加到 8829-10756 例），需要增加 287-474 张病床。到 2031 年，约 45%的骨折将发生在 85 岁及以上的人群中，而 2004 年这一比例为 34%。人口统计学的预测变化因地区而异，因此需要对资源配置进行本地化规划。
结论：人口结构的变化将对髋部骨折患者的医疗保健服务产生重大影响。需要增加急性骨科护理的能力，并审查护理模式，以确保提供充足的资源。
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