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对于苏格兰特定城市人口而言,社会剥夺影响成人肱骨近端骨折的流行病学特征及预后。

Social deprivation influences the epidemiology and outcome of proximal humeral fractures in adults for a defined urban population of Scotland.

作者信息

Clement N D, McQueen M M, Court-Brown C M

机构信息

Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK,

出版信息

Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1039-46. doi: 10.1007/s00590-013-1301-3. Epub 2013 Sep 6.

Abstract

We present the epidemiology and incidence of proximal humeral fractures over a 17-year period for a defined urban population that represents approximately 13% of the population in Scotland, and functional outcome in relation to the socio-economic status of the patient. The incidence of proximal humeral fractures significantly increased during the study period from 47.9/10(5)/year to 98.7/10(5)/year in 2008 (p < 0.0001), which was greatest for the most socially deprived patients reaching 274.2/10(5)/year in 2008 (p < 0.0001). The most deprived patients sustained their fracture 4 years earlier than the most affluent patients (p = 0.026). Social deprivation was an independent predictor, after adjusting for other confounding variables using multivariable regression analysis, of a significantly worse functional outcome according to the Constant score at 1 year (p = 0.046). Preventative measures, especially for the most socially deprived patients within society, need to be instigated urgently to address the increasing incidence of proximal humeral fractures and alleviate the burden of these morbid fractures in the future. Whether the observed increased incidence is generalisable to a national population would need to be confirmed in future studies.

摘要

我们呈现了一个特定城市人群在17年期间肱骨近端骨折的流行病学情况和发病率,该人群约占苏格兰人口的13%,同时还展示了与患者社会经济状况相关的功能结局。在研究期间,肱骨近端骨折的发病率显著增加,从每年47.9/10⁵增至2008年的98.7/10⁵(p < 0.0001),其中社会经济状况最差的患者发病率最高,2008年达到274.2/10⁵(p < 0.0001)。社会经济状况最差的患者发生骨折的时间比最富裕的患者早4年(p = 0.026)。在使用多变量回归分析对其他混杂变量进行调整后,社会经济剥夺是1年时根据Constant评分得出的功能结局显著更差的独立预测因素(p = 0.046)。迫切需要采取预防措施,尤其是针对社会中社会经济状况最差的患者,以应对肱骨近端骨折发病率的上升,并减轻这些致残性骨折未来的负担。观察到的发病率增加是否适用于全国人群,需要在未来的研究中加以证实。

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