监测澳大利亚南澳大利亚州髋部骨折管理的进展情况。

Monitoring progress in the management of hip fractures in South Australia, Australia.

机构信息

Discipline of Public Health, University of Adelaide, Adelaide, SA 5005, Australia.

出版信息

Arch Osteoporos. 2012;7:267-73. doi: 10.1007/s11657-012-0107-y.

DOI:10.1007/s11657-012-0107-y

PMID:23192591

Abstract

UNLABELLED

The aim of this study was to assess trends in hip fracture rates and outcomes following hospitalisation for hip fracture. Hip fracture admissions increased over the study period. Men fared worst in terms of higher absolute mortality. Refracture rates and male health outcomes require further attention.

PURPOSE

The aim of this study was to assess trends in hip fracture rates and outcomes following hospitalisation for hip fracture in South Australia (SA).

METHODS

Analysis of routinely collected, linked hospital separations data, of patients admitted to public and private hospitals in SA with a principal diagnosis of femoral neck fracture between July 2002 and June 2008 was done. Main outcome measures include number and rates of hospital admissions, 30-day in-hospital and 1-year mortality following a first hip fracture and subsequent event rates, by age and sex.

RESULTS

Unadjusted hip fracture admissions increased in SA from 2002 to 2008 by 20 %, age-standardised (adjusted) admission rates increased overall (+5 %, p = 0.215) and significantly amongst males (+26 %, p = 0.001), while there was no change among women (−1 %, p = 0.763). Within 1 year of a hip fracture, 7 % had broken another bone (5 % had refractured a hip). At 1 year post-fracture, unadjusted mortality was consistently and considerably higher amongst men compared to women (33 versus 19 %, p < 0.001). Age-standardised mortality from admission to 1 year fell but not statistically significantly by 15 % in women (p = 0.131) and 8 % in men (p = 0.510). Women had a reduction in age-standardised in-hospital mortality over time (p = 0.048); there was a non-significant decline in men (p = 0.080).

CONCLUSIONS

Hip fracture admissions in SA increased over the study period and this appears to be driven by an increase in admissions amongst men. Men fared worst in terms of higher absolute mortality. There is some evidence to suggest refracture rates and male health outcomes require further attention.

摘要

目的

本研究旨在评估南澳大利亚（SA）髋关节骨折住院患者的髋关节骨折发生率和结局趋势。

方法

对 2002 年 7 月至 2008 年 6 月期间在 SA 公立医院和私立医院因股骨颈骨折住院的患者进行了常规收集的、链接的住院分离数据的分析。主要观察指标包括首次髋关节骨折后 30 天住院内和 1 年死亡率以及按年龄和性别划分的后续事件发生率。

结果

未经调整的髋关节骨折住院人数在 SA 从 2002 年至 2008 年增加了 20%，年龄标准化（调整）入院率总体上增加（+5%，p=0.215），男性明显增加（+26%，p=0.001），而女性没有变化（-1%，p=0.763）。在髋关节骨折后 1 年内，有 7%的患者再次骨折（5%的患者髋关节再次骨折）。在骨折后 1 年，未经调整的死亡率男性明显高于女性（33%比 19%，p<0.001）。从入院到 1 年的标准化死亡率女性下降了 15%（p=0.131），男性下降了 8%（p=0.510），但无统计学意义。女性的标准化住院死亡率随时间呈下降趋势（p=0.048）；男性的死亡率没有明显下降（p=0.080）。