Tucker A, Donnelly K J, McDonald S, Craig J, Foster A P, Acton J D
Altnagelvin Area Hospital, Glenshane Road, Londonderry, BT47 6SB, Northern Ireland, UK.
Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK.
Bone Joint J. 2017 Sep;99-B(9):1223-1231. doi: 10.1302/0301-620X.99B9.BJJ-2016-1284.R1.
We reviewed all patients who sustained a fracture of the hip and were treated in Northern Ireland over a period of 15 years to identify trends in incidence, the demographics of the patients, the rates of mortality, the configuration of the fracture and the choice of implant.
Since 01 January 2001 data about every fracture of the hip sustained in an adult have been collected centrally in Northern Ireland. All adults with such a fracture between 2000 and 2015 were included in the study. Temporal changes in their demographics, the mode of treatment, and outcomes including mortality were analysed.
The incidence of fractures of the hip, in Northern Ireland, rose from 54 in 100 000 in 2000 to 86 in 100 000 in 2015. If these trends continue, we predict this rising to 128 in 100 000 in 2030. We found that these patients are becoming older and increasingly frail, as assessed by the American Association of Anesthesiology grade. Complex extracapsular fractures have become more common since 2009, which may explain the increased use of cephalomedullary nails. Despite increasing frailty, the 30-day and 12-month rates of mortality fell significantly (p = 0.002 and 0.001, respectively).
Fractures of the hip are becoming more common and more complex in an aging, increasingly frail population. We expect these trends to continue. This will place an increasing economic and clinical strain on healthcare systems. Forward planning is essential to put systems in place that can deal with the increasing demand. Cite this article: 2017;99-B:1223-31.
我们回顾了北爱尔兰15年间所有髋部骨折并接受治疗的患者，以确定发病率趋势、患者人口统计学特征、死亡率、骨折类型及植入物选择情况。
自2001年1月1日起，北爱尔兰集中收集了所有成人髋部骨折的数据。纳入了2000年至2015年间所有此类骨折的成人患者。分析了他们人口统计学特征、治疗方式及包括死亡率在内的结局的时间变化情况。
北爱尔兰髋部骨折的发病率从2000年的每10万人中54例升至2015年的每10万人中86例。如果这些趋势持续下去，预计到2030年将升至每10万人中128例。我们发现，根据美国麻醉医师协会分级评估，这些患者年龄越来越大，身体越来越虚弱。自2009年以来，复杂的囊外骨折变得更为常见，这可能解释了髓内钉使用的增加。尽管身体越来越虚弱，但30天和12个月的死亡率显著下降（分别为p = 0.002和0.001）。
在老龄化、日益虚弱的人群中，髋部骨折正变得越来越常见且越来越复杂。我们预计这些趋势将持续。这将给医疗系统带来越来越大的经济和临床压力。前瞻性规划对于建立能够应对不断增长需求的系统至关重要。引用本文：2017;99-B:1223 - 31。
