Ha Yong-Chan, Baek Ji-Hoon, Ko Young-Bong, Park Sang-Min, Song Sang-Heon
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul, 156-755, South Korea.
J Bone Miner Metab. 2015 Sep;33(5):547-52. doi: 10.1007/s00774-014-0616-4. Epub 2014 Sep 17.
Although vertebral fracture in patients is a predictor of subsequent hip fracture, no study has assessed the mortality and functional outcome in hip fracture patients with previous vertebral fracture. Between September 2009 and December 2012, we evaluated 246 patients over 50-years-of-age diagnosed with femoral neck or intertrochanteric fractures who underwent surgery. The patients were categorized into two groups and two subgroups. Group Ia comprised 150 patients with previous vertebral fracture at the time of hip fracture. Group Ib comprised 96 patients with no vertebral fracture. Group IIa consisted of 76 patients <80-years-of-age with previous vertebral fracture. Group IIb comprised 69 patients <80-years-of-age without previous vertebral fracture. The mortality rate and functional outcome of osteoporotic hip fracture patients with and without vertebral fractures were compared. The cumulative mortality rate at 6 and 12 months post-fracture was 19 and 23 % in Group Ia and 6 and 7 % in Group Ib, respectively. In subgroup analysis, the cumulative mortality rate at 6 and 12 months was 13 and 17 % in Group IIa and 3 and 4 % in Group IIb, respectively. Shut-in patients at the final follow-up included 51 of 103 (49.5 %) patients in Group Ia and 19 of 83 (22.9 %) patients in Group Ib. In subgroup analysis, the shut-in patients included 18 of 58 (31.0 %) patients in Group IIa and 10 of 62 (16.1 %) patients in Group IIb. Previous vertebral fracture was associated with a poor functional outcome and increased mortality in patients with hip fracture.
虽然患者发生椎体骨折是后续髋部骨折的一个预测指标，但尚无研究评估既往有椎体骨折的髋部骨折患者的死亡率和功能结局。在2009年9月至2012年12月期间，我们评估了246例年龄超过50岁、诊断为股骨颈或转子间骨折并接受手术的患者。这些患者被分为两组及两个亚组。Ia组包括150例在髋部骨折时已有椎体骨折的患者。Ib组包括96例无椎体骨折的患者。IIa组由76例年龄<80岁且有椎体骨折的患者组成。IIb组包括69例年龄<80岁且无椎体骨折的患者。比较了有和无椎体骨折的骨质疏松性髋部骨折患者的死亡率和功能结局。骨折后6个月和12个月时，Ia组的累积死亡率分别为19%和23%，Ib组分别为6%和7%。在亚组分析中，IIa组骨折后6个月和12个月时的累积死亡率分别为13%和17%，IIb组分别为3%和4%。末次随访时的卧床患者在Ia组103例患者中有51例（49.5%），在Ib组83例患者中有19例（22.9%）。在亚组分析中，卧床患者在IIa组58例患者中有18例（31.0%），在IIb组62例患者中有10例（16.1%）。既往椎体骨折与髋部骨折患者功能结局不佳及死亡率增加相关。
