Rosengren Björn E, Karlsson Magnus, Petersson Ingemar, Englund Martin
Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics, Clinical Sciences Malmö, Lund University, Malmö, Sweden.
J Bone Miner Res. 2015 Mar;30(3):535-42. doi: 10.1002/jbmr.2370.
Recent reports on adult fracture epidemiology have focused mainly on the hip in the elderly, in whom increasing rates lately have changed to a decline. New reports of the preponderance of nonhip fractures in health expenditure call for a wider scope. We therefore examined current overall and site-specific fracture epidemiology in adults. We ascertained all fractures diagnosed in inpatient and outpatient care in all men and women aged 20 years or older in Skåne County, Sweden, from 1999 to 2010 (10 million person-years). For each fracture type, we estimated age-specific and sex-specific rates and evaluated potential time trends. We found 205,908 fractures yielding an overall fracture rate of 192 per 10,000 person-years. The age-standardized overall fracture rate increased by 1.2 per 10,000 and year (95% confidence interval, 0.8 to 1.5), but time trends were different for different fracture types, age strata, and for men and women. For example, in both women and men aged ≥50 years the rates of proximal humerus fracture increased (0.6 and 0.2 per 10,000 and year, respectively) while hip fracture rates declined (-1.0 and -0.3 per 10,000/year, respectively). Overall age-specific number of fractures increased with age in women but was stable in men. The increasing overall fracture rate is a major concern in the context of a growing and aging population. Effective and affordable preventive strategies and treatments should be an urgent priority to meet the challenges, especially in older women in whom most fractures occur. Comprehensive current detailed data, as provided in this study, may serve as reference for projections and for cost calculations of fracture care in other settings before results of similar examinations are available there.
近期有关成人骨折流行病学的报告主要聚焦于老年人的髋部骨折，其发生率近来已从上升转为下降。新报告指出非髋部骨折在医疗支出中占比更大，这就需要更广泛的研究范围。因此，我们研究了成人当前的总体骨折情况以及特定部位的骨折流行病学。我们确定了1999年至2010年瑞典斯科讷郡所有20岁及以上男女在住院和门诊治疗中诊断出的所有骨折（1000万人年）。对于每种骨折类型，我们估计了特定年龄和性别的发生率，并评估了潜在的时间趋势。我们发现205,908例骨折，总体骨折发生率为每10,000人年192例。年龄标准化后的总体骨折发生率每年每10,000人增加1.2例（95%置信区间为0.8至1.5），但不同骨折类型、年龄层以及男性和女性的时间趋势有所不同。例如，在50岁及以上的男性和女性中，肱骨近端骨折发生率均有所上升（分别为每年每10,000人0.6例和0.2例），而髋部骨折发生率则下降（分别为每年每10,000人-1.0例和-0.3例）。女性骨折的总体特定年龄数量随年龄增长而增加，而男性则保持稳定。在人口不断增长和老龄化的背景下，总体骨折发生率的上升是一个主要问题。有效且经济实惠的预防策略和治疗方法应成为应对这些挑战的紧迫优先事项，尤其是在发生大多数骨折的老年女性中。本研究提供的全面详细的当前数据，可作为其他地区在获得类似检查结果之前进行骨折护理预测和成本计算的参考。
