Shen Hsiu-Nien, Lin Wei-Ting, Lu Chin-Li, Li Chung-Yi
Department of Intensive Care Medicine, Chi Mei Medical Center, No. 901 Chung-Hwa Road, Yong-Kang district, Tainan 71004, Taiwan.
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
Int J Environ Res Public Health. 2015 Feb 16;12(2):2249-61. doi: 10.3390/ijerph120202249.
Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures.
Data regarding older (≥65 years) physicians (n = 4303) and matched non-medical persons (control) were retrieved from Taiwan's National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR) of hip fracture associated with older physicians.
The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively), whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively). Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37-0.79); by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged.
Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures.
骨质疏松症在病理生理上与转子间骨折相关,而且这种情况通过生活方式的改变比颈椎骨折更可预防。我们调查了由于转子间骨折较少,有健康意识的老年医生是否髋部骨折风险较低。
从台湾国民健康保险理赔数据中检索有关老年(≥65岁)医生(n = 4303)和匹配的非医疗人员(对照)的数据。所有受试者均来自国民健康保险研究数据库,索引日期为2000年1月1日至2008年12月31日。建立Cox比例风险和竞争风险回归模型以估计与老年医生相关的髋部骨折风险比(HR)。
老年医生转子间骨折的发病率低于对照组(分别为每1000人年1.73例和3.07例),而两组颈椎骨折的发病率相似(分别为每1000人年2.45例和2.12例)。老年医生转子间骨折的风险比对照组低46%(调整后HR 0.54,95%置信区间0.37 - 0.79);相比之下,两组颈椎骨折的风险相当。竞争风险模型估计的HR保持不变。
我们的研究结果表明,健康风险意识可能对转子间髋部骨折具有显著的预防作用。