Department of Orthopedic Surgery, Halla General Hospital, Jeju, Korea.
J Korean Med Sci. 2013 Jul;28(7):1089-94. doi: 10.3346/jkms.2013.28.7.1089. Epub 2013 Jul 3.
This prospective cohort study was performed to estimate the morbidity and mortality with 790 patients over 50-yr of age that sustained a femoral neck or intertrochanteric fracture from 2002 to 2006, followed-up for a mean of 6 yr (range, 4 to 9 yr). Crude and annual standardized mortality ratios (SMRs) were calculated; and mortalities in the cohort and the age and sex matched general population were compared. The risk factors on mortality and activities pre- and post-injury were assessed. Accumulated mortality was 16.7% (132 patients) at 1 yr, 45.8% (337 patients) at 5 yr, and 60% (372 patients) at 8 yr. SMR at 5 yr post-injury was 1.3 times that of the general population. Multivariate analysis demonstrated that age (OR, 1.074; 95% CI, 1.050-1.097; P<0.001), woman (OR, 1.893; 95% CI, 1.207-2.968; P=0.005), and medical comorbidity (OR, 1.334; 95% CI, 1.167-1.524 P<0.001) were independently associated with mortality after hip fracture. Only 59 of the 150 patients (39.3%) who were able to ambulate normally outdoors at preinjury retained this ability at final follow-up. Patients with a hip fracture exhibits higher mortality at up to 5 yr than general population. Age and a preinjury comorbidity are associated with mortality.
这项前瞻性队列研究对 2002 年至 2006 年间年龄在 50 岁以上、股骨颈或转子间骨折的 790 例患者进行了研究,随访平均 6 年(范围 4 至 9 年)。计算了粗死亡率和年标准化死亡率比(SMR),并比较了队列中的死亡率和年龄及性别匹配的一般人群的死亡率。评估了死亡的危险因素以及受伤前后的活动情况。1 年时死亡率为 16.7%(132 例),5 年时为 45.8%(337 例),8 年时为 60%(372 例)。受伤后 5 年的 SMR 是一般人群的 1.3 倍。多变量分析表明,年龄(OR,1.074;95%CI,1.050-1.097;P<0.001)、女性(OR,1.893;95%CI,1.207-2.968;P=0.005)和合并内科疾病(OR,1.334;95%CI,1.167-1.524;P<0.001)与髋部骨折后死亡率独立相关。在受伤前能够正常户外活动的 150 例患者中,只有 59 例(39.3%)在最终随访时保留了这种能力。髋部骨折患者的死亡率在 5 年内高于一般人群。年龄和术前合并症与死亡率相关。