Hindmarsh Diane, Loh Ming, Finch Caroline F, Hayen Andrew, Close Jacqueline C T
School of Mathematics and Applied Statistics, University of Wollongong, Sydney, New South Wales, Australia.
Australas J Ageing. 2014 Sep;33(3):E1-7. doi: 10.1111/j.1741-6612.2012.00638.x. Epub 2012 Sep 30.
To assess the effect of comorbidity on relative survival after hip fracture.
Relative survival analysis was undertaken in 16 838 fall-related hip fracture hospitalisations in New South Wales, Australia. Comorbidity was measured on the basis of additional diagnosis codes on the same hospital separation as the hip fracture using the Charlson Comorbidity Index (CCI). Interval-specific relative survival and relative excess risk of death were calculated.
Comorbidity was more frequently documented in men than women across the age groups. Survival decreased with increasing age and increasing comorbidity, but the relative impact of comorbidity was greater in the younger-old age group (65-74 years). The excess mortality in men was not accounted for by age or comorbidities.
This study demonstrates an association between increasing comorbidity and death particularly in the first 3 months post hip fracture. It also highlights a relative excess risk of death in men after hip fracture after adjusting for age and comorbidity.
评估合并症对髋部骨折后相对生存的影响。
对澳大利亚新南威尔士州16838例与跌倒相关的髋部骨折住院病例进行相对生存分析。使用Charlson合并症指数（CCI），根据与髋部骨折同一住院病历上的附加诊断编码来衡量合并症。计算特定区间的相对生存和相对超额死亡风险。
在各年龄组中，男性比女性更常记录有合并症。生存率随年龄增长和合并症增加而降低，但合并症在年轻老年组（65 - 74岁）中的相对影响更大。男性的超额死亡率不能用年龄或合并症来解释。
本研究表明合并症增加与死亡之间存在关联，尤其是在髋部骨折后的前3个月。它还强调了在调整年龄和合并症后，男性髋部骨折后存在相对超额死亡风险。
