Lobo Elena, Marcos Guillermo, Santabárbara Javier, Salvador-Rosés Helena, Lobo-Escolar Luis, De la Cámara Concepción, Aso Alberto, Lobo-Escolar Antonio
Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.
Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain; Servicio de Archivos, Hospital Clínico Universitario, Avda. San Juan Bosco 15, 50009 Zaragoza, Spain.
Maturitas. 2017 Mar;97:38-43. doi: 10.1016/j.maturitas.2016.12.009. Epub 2016 Dec 28.
To analyze independently in men and women the incidence rate of and risk factors for hip fracture in a southern European population. Illiteracy, dementia, clinically significant depression and disability were factors to receive special emphasis.
A community sample of 4803 individuals aged over 55 years was assessed in a two-phase case-finding study in Zaragoza, Spain, and was followed up for 16 years. Medical history and psychiatric history were collected with standardized instruments, including the History and Aetiology Schedule, the Geriatric Mental State (GMS) scale, and a Risk Factors Questionnaire. Operational criteria were used to define covariates, including diagnostic criteria for both dementia and depression. The statistical analysis included calculations of incidence rate, IR; women/men incidence rate ratio (IRR); and Hazard Ratios (HR) in multivariate Cox proportional hazards regression models.
Cases of hip fracture (International Classification of Diseases, WHO) identified in the treating hospitals, validated by blinded researchers.
Hip fractures were more frequent among women than men (IRR=3.1). Illiteracy (HR=1.55) and depression (HR=1.44) increased the risk in women, and smoking (HR=2.13) and disability in basic activities of daily living (HR=3.14) increased the risk in men. Dementia was associated with an increased risk in an univariate analysis, but the association disappeared (power=85% in men, 95% in women) when disability was included in the multivariate models.
The IR of hip fractures was three times higher among women. Illiteracy and clinically significant depression among women and active smoking and disability (HR=3.14) among men independently increased the risk, but dementia did not.
在欧洲南部人群中，分别分析男性和女性髋部骨折的发病率及危险因素。文盲、痴呆、具有临床意义的抑郁症和残疾是需要特别强调的因素。
在西班牙萨拉戈萨进行的一项两阶段病例发现研究中，对4803名55岁以上的社区样本进行了评估，并随访16年。使用标准化工具收集病史和精神病史，包括病史和病因学调查表、老年精神状态（GMS）量表以及危险因素问卷。采用操作标准定义协变量，包括痴呆和抑郁症的诊断标准。统计分析包括发病率（IR）计算、女性/男性发病率比（IRR）以及多变量Cox比例风险回归模型中的风险比（HR）。
在治疗医院确定的髋部骨折病例（世界卫生组织国际疾病分类），由不知情的研究人员进行验证。
女性髋部骨折比男性更常见（IRR = 3.1）。文盲（HR = 1.55）和抑郁症（HR = 1.44）增加了女性的风险，吸烟（HR = 2.13）和日常生活基本活动中的残疾（HR = 3.14）增加了男性的风险。在单变量分析中，痴呆与风险增加相关，但在多变量模型中纳入残疾因素后，这种关联消失（男性的检验效能为85%，女性为95%）。
女性髋部骨折的发病率是男性的三倍。女性中的文盲和具有临床意义的抑郁症以及男性中的主动吸烟和残疾（HR = 3.14）独立增加了风险，但痴呆没有。
