Quah C, Boulton C, Moran C
Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
J Bone Joint Surg Br. 2011 Jun;93(6):801-5. doi: 10.1302/0301-620X.93B6.24936.
This is the first study to use the English Indices of Multiple Deprivation 2007, the Government's official measure of multiple deprivation, to analyse the effect of socioeconomic status on the incidence of fractures of the hip and their outcome and mortality. Our sample consisted of all patients admitted to hospital with a fracture of the hip (n = 7511) in Nottingham between 1999 and 2009. The incidence was 1.3 times higher (p = 0.038) in the most deprived populations than in the least deprived; the most deprived suffered a fracture, on average, 1.1 years earlier (82.0 years versus 83.1 years, p < 0.001). The mortality rate proved to be significantly higher in the most deprived population (log-rank test, p = 0.033), who also had a higher number of comorbidities (p = 0.001). This study has shown an increase in the incidence of fracture of the hip in the most deprived population, but no association between socioeconomic status and mortality at 30 days. Preventative programmes aimed at reducing the risk of hip fracture should be targeted towards the more deprived if they are to make a substantial impact.
这是第一项使用2007年英国多重贫困指数(政府衡量多重贫困的官方指标)来分析社会经济地位对髋部骨折发生率、其后果及死亡率影响的研究。我们的样本包括1999年至2009年期间在诺丁汉因髋部骨折入院的所有患者(n = 7511)。最贫困人群的发病率比最不贫困人群高1.3倍(p = 0.038);最贫困人群平均骨折时间要早1.1年(82.0岁对83.1岁,p < 0.001)。结果表明,最贫困人群的死亡率显著更高(对数秩检验,p = 0.033),他们的合并症数量也更多(p = 0.001)。本研究显示,最贫困人群的髋部骨折发生率有所上升,但社会经济地位与30天死亡率之间无关联。旨在降低髋部骨折风险的预防项目若要产生重大影响,应针对更贫困人群。