Center Jacqueline R
Bone Biology Division, Garvan Institute of Medical Research, St Vincent's Hospital Clinical School, School of Medicine, University of New South Wales, 384 Victoria St, Darlinghurst, NSW, 2010, Australia.
Curr Osteoporos Rep. 2017 Apr;15(2):88-95. doi: 10.1007/s11914-017-0352-5.
This review aims to highlight important clinical findings from the over 25 year-long Dubbo Osteoporosis Epidemiology Study particularly focusing on outcomes post fracture.
Every low trauma fracture in the elderly is associated with an increased risk of a subsequent fracture, with a higher risk in men than women. All major or proximal fractures and even minor fractures in the very elderly or minor fractures that are then followed by re-fracture are associated with premature mortality, greatest in the first 5 years post fracture. Having a subsequent fracture further increases this high mortality risk, but if an individual survives the high risk period, their risk returns to that of the background population. Non-hip non-vertebral fractures account for a significant proportion of the premature mortality. Despite an improvement in overall health and population mortality over the years, excess mortality post fracture has not changed in the last 2 decades. All low trauma, fractures in the elderly herald a high risk of poor outcomes, particularly in the first few years post fracture. Early intervention should be initiated.
本综述旨在突出超过25年的达博骨质疏松症流行病学研究中的重要临床发现,尤其关注骨折后的结局。
老年人的每一次低创伤骨折都与后续骨折风险增加相关,男性风险高于女性。所有主要或近端骨折,甚至极老年人的轻微骨折或随后发生再骨折的轻微骨折都与过早死亡相关,在骨折后的头5年最为显著。发生后续骨折会进一步增加这种高死亡风险,但如果个体在高风险期存活下来,其风险会恢复到背景人群的水平。非髋部非椎体骨折占过早死亡的很大比例。尽管多年来总体健康状况和人群死亡率有所改善,但骨折后超额死亡率在过去20年中并未改变。老年人的所有低创伤骨折都预示着不良结局的高风险,尤其是在骨折后的头几年。应尽早进行干预。