Department of Orthopaedic Surgery, Faculty of Medicine, Thammasat University Pathum Thani, Thailand.
Tohoku J Exp Med. 2012 Feb;226(2):129-35. doi: 10.1620/tjem.226.129.
Little is known about the effect of a subsequent osteoporotic vertebral compression fracture on the survival rate of patients with a previous hip fracture. In this study, we aimed to compare the survival rates of hip fracture patients with and without subsequent osteoporotic vertebral compression fractures and determine the risk factors associated with subsequent fracture. During 2000-2008, 933 initial hip fracture patients were reviewed and divided into two groups: subsequent fracture group (160 patients) and single hip fracture group (i.e., no subsequent fracture; 773 patients). All information pertaining to their most recent fracture event(s), including mortality causes/rates, were recorded. Differences in mortality rates and hazard ratios (HRs) between the two groups were also analyzed. The 1-year and 1-to-5-year mortality rates were 1.3% and 1.9%, respectively, in the subsequent fracture group, and 4.7% and 1.4%, respectively, in the single hip fracture group, with no significant differences observed. Interestingly, the HR for mortality was significantly higher in the single hip fracture group than in the subsequent fracture group (p < 0.05). The significant risk factors for subsequent fractures were identified as knee osteoarthritis, neurological disease, and an initial hip fracture with intertrochanteric involvement. Our findings indicate that the occurrence of a vertebral compression fracture after an initial hip fracture does not greatly impact patient survival. Conversely, patients presenting with a single hip fracture have a significantly higher mortality-HR, indicating that single hip fracture patients without subsequent fracture should be provided with the same standard of care as patients with subsequent fractures.
对于先前发生髋部骨折的患者，随后发生骨质疏松性椎体压缩骨折对其生存率的影响知之甚少。在本研究中，我们旨在比较先前发生髋部骨折且随后发生骨质疏松性椎体压缩骨折与未发生随后骨折患者的生存率，并确定与随后骨折相关的风险因素。在 2000 年至 2008 年期间，我们对 933 例初次髋部骨折患者进行了回顾性分析，并将其分为两组：随后发生骨折组（160 例）和单髋部骨折组（即无随后骨折；773 例）。记录了与最近骨折事件（包括死亡率原因/比率）相关的所有信息。还分析了两组之间死亡率和风险比（HR）的差异。在随后发生骨折组中，1 年和 1 至 5 年的死亡率分别为 1.3%和 1.9%，在单髋部骨折组中，死亡率分别为 4.7%和 1.4%，差异无统计学意义。有趣的是，单髋部骨折组的死亡风险 HR 明显高于随后发生骨折组（p < 0.05）。随后发生骨折的显著风险因素为膝骨关节炎、神经疾病和初始髋部骨折伴转子间受累。我们的研究结果表明，初次髋部骨折后发生椎体压缩骨折不会对患者的生存率产生重大影响。相反，单髋部骨折患者的死亡率 HR 明显更高，这表明没有随后发生骨折的单髋部骨折患者应与随后发生骨折的患者一样接受相同的治疗。
