School of Medicine, University of California-Davis, 2921 Stockton Boulevard, Sacramento, CA 95817, USA.
Arthritis Care Res (Hoboken). 2012 May;64(5):751-7. doi: 10.1002/acr.21580.
To evaluate the recent epidemiology of hip fractures in the US.
We identified hip fracture cases from the 2008 Nationwide Emergency Department Sample, which contains more than 28 million emergency department (ED) records.
In 2008, approximately 341,000 (95% confidence interval 323,000-358,000) patients visited EDs with hip fractures. Of those, 90% were age >60 years. Between ages 60-85 years, the risk of fracture doubled for every 5- to 6-year increase in age. However, the hip fracture risk increased slowly after age 85 years. The overall trochanteric-to-cervical fracture ratio was nearly 2:1. The risk of trochanteric fracture increased faster with age compared with the risk of cervical fracture. At age 85 years, the rates of trochanteric and cervical fractures (per 100,000) were 1,300 and 700, respectively, among women and 800 and 500, respectively, among men.
The slowed growth of hip fracture risk after age 85 years suggests that the eldest old group may have a distinct hip fracture risk. Our study showed that trochanteric fractures were twice as common as cervical fractures. Because trochanteric fractures are more closely related to severe and generalized bone loss than cervical fractures, we hypothesize that the high incidence rate of trochanteric fractures in the US suggests that osteoporosis is a health problem that is linked to hip fracture. In addition to improved safety measures to reduce falls, rigorous preventive treatments of osteoporosis may be needed.
评估美国近期髋部骨折的流行病学情况。
我们从包含超过 2800 万急诊部（ED）记录的 2008 年全国急诊部抽样调查中确定髋部骨折病例。
2008 年，约有 34.1 万名（95%置信区间 32.3 万至 35.8 万）患者因髋部骨折就诊于 ED。其中 90%年龄 >60 岁。在 60-85 岁之间，骨折风险每增加 5-6 岁就会增加一倍。然而，85 岁以后髋部骨折风险增加缓慢。转子间到颈骨骨折的总体比例接近 2:1。与颈骨骨折相比，转子间骨折的风险随年龄增长更快。在 85 岁时，女性转子间和颈骨骨折的发生率（每 10 万人）分别为 1300 和 700，男性分别为 800 和 500。
85 岁以后髋部骨折风险增长缓慢表明最年长的老年人群可能具有独特的髋部骨折风险。我们的研究表明，转子间骨折比颈骨骨折更为常见。由于转子间骨折与严重和广泛的骨丢失比颈骨骨折更为密切相关，我们推测美国转子间骨折的高发生率表明骨质疏松症是与髋部骨折相关的健康问题。除了改进安全措施以减少跌倒外，可能还需要对骨质疏松症进行严格的预防治疗。
