Primary Health Care Center, Eap Sardenya-Biomedical Resarch Institute Sant Pau (IIB Sant Pau), c/Sardenya 466, Barcelona, Spain.
Osteoporos Int. 2014 Jun;25(6):1751-8. doi: 10.1007/s00198-014-2682-9. Epub 2014 Mar 28.
We used a large population-based health care database to determine the impact of common co-morbidities on hip fracture risk amongst elderly men. We demonstrated that diabetes, chronic obstructive pulmonary disease, renal failure, HIV infection, dementia, and cerebrovascular disease are independent predictors of hip fracture, as is a Charlson score of ≥ 3.
Risk factors for hip fractures in men are still unclear. We aimed to identify common co-morbidities (amongst those in the Charlson index) that confer an increased risk of hip fracture amongst elderly men.
We conducted a population-based cohort study using data from the SIDIAP (Q) database. SIDIAP(Q) contains primary care and hospital inpatient records of a representative 30% of the population of Catalonia, Spain (>2 million people). All men aged ≥ 65 years registered on 1 January 2007 were followed up until 31 December 2009. Both exposure (co-morbidities in the Charlson index) and outcome (incident hip fractures) were ascertained using ICD codes. Poisson regression models were fitted to estimate the effect of (1) each individual co-morbidity and (2) the composite Charlson index score, on hip fracture risk, after adjustment for age, body mass index, smoking, alcohol drinking, and use of oral glucocorticoids.
We observed 186,171 men for a median (inter-quartile range) of 2.99 (2.37-2.99) years. In this time, 1,718 (0.92%) participants had a hip fracture. The following co-morbidities were independently associated with hip fractures: diabetes mellitus, chronic obstructive pulmonary disease (COPD), renal failure, HIV infection, dementia, and cerebrovascular disease. A Charlson score of ≥ 3 conferred an increased hip fracture risk.
Common co-morbidities including diabetes, COPD, cerebrovascular disease, renal failure, and HIV infection are independently associated with an increased risk of hip fracture in elderly men. A Charlson score of 3 or more is associated with a 50% higher risk of hip fracture in this population.
我们使用大型基于人群的医疗保健数据库来确定常见合并症对老年男性髋部骨折风险的影响。我们证明，糖尿病、慢性阻塞性肺疾病、肾衰竭、HIV 感染、痴呆和脑血管疾病是髋部骨折的独立预测因素，Charlson 评分≥3 也是如此。
男性髋部骨折的危险因素仍不清楚。我们旨在确定常见合并症（Charlson 指数中的那些），这些合并症会增加老年男性髋部骨折的风险。
我们使用 SIDIAP（Q）数据库进行了一项基于人群的队列研究。SIDIAP（Q）包含西班牙加泰罗尼亚地区代表性的 30%人群（超过 200 万人）的初级保健和住院患者记录。所有 2007 年 1 月 1 日登记的年龄≥65 岁的男性均随访至 2009 年 12 月 31 日。使用 ICD 代码确定暴露（Charlson 指数中的合并症）和结果（新发髋部骨折）。使用泊松回归模型估计（1）每种单独的合并症和（2）复合 Charlson 指数评分对髋部骨折风险的影响，调整年龄、体重指数、吸烟、饮酒和口服糖皮质激素的使用。
我们观察了 186171 名男性，中位（四分位距）为 2.99（2.37-2.99）年。在此期间，有 1718 名（0.92%）参与者发生了髋部骨折。以下合并症与髋部骨折独立相关：糖尿病、慢性阻塞性肺疾病（COPD）、肾衰竭、HIV 感染、痴呆和脑血管疾病。Charlson 评分≥3 与髋部骨折风险增加相关。
常见合并症，包括糖尿病、COPD、脑血管疾病、肾衰竭和 HIV 感染，与老年男性髋部骨折风险增加独立相关。Charlson 评分为 3 或更高与该人群髋部骨折风险增加 50%相关。
