Kelly M A, McGowan B, McKenna M J, Bennett K, Carey J J, Whelan B, Silke C
The North Western Rheumatology Unit, Our Lady's Hospital, Manorhamilton, Co Leitrim, Ireland.
St. Vincent's University Hospital, University College Dublin, Dublin, Ireland.
Ir J Med Sci. 2018 Aug;187(3):601-608. doi: 10.1007/s11845-018-1743-z. Epub 2018 Jan 20.
We analysed hospital admissions and bed occupancy for fragility fractures in Ireland over a 15-year period to assess fracture admission trends and to project admissions over the next three decades.
We used the Hospital In-Patient Enquiry (HIPE) scheme to extract data on fracture admissions to Irish hospitals between 2000 and 2014 inclusive. We calculated absolute numbers and age-standardised rates of hospitalisations for men and women ≥ 50 years for each osteoporotic-type fracture. We projected fracture numbers and bed days using these trends, and associated costs to 2046 based on 2014 rates.
The absolute number of all fragility fracture admissions increased by 30% between 2000 and 2014, for both men (40%) and women (27%). In-patient bed days for osteoporotic fractures have increased by 51% in the same period. Hip fractures dominated admissions, accounting for 36.5% of all admissions and almost half (46.7%) of all bed days. Age-standardised rates of hip fracture admission decreased significantly (p < 0.001) in women, but not in men, while rates of non-hip osteoporotic fracture admissions have not changed significantly for men or women. Hospitalisations for all osteoporotic fractures are projected to increase by 150% to 31,605 in 2046, 58% of whom will be 80 years or older.
There has been a significant increase in the number of fracture admissions in Irish men and women over the past 15 years. This is projected to increase further over the next three decades which will place a significant burden on the Irish healthcare system.
我们分析了爱尔兰15年间因脆性骨折而住院的情况及床位占用情况,以评估骨折住院趋势,并预测未来三十年的住院人数。
我们利用医院住院病人查询(HIPE)计划提取了2000年至2014年(含)期间爱尔兰医院骨折住院的数据。我们计算了≥50岁男性和女性每种骨质疏松性骨折的住院绝对数和年龄标准化率。我们根据这些趋势预测了骨折数量和住院天数,并根据2014年的费率计算了到2046年的相关费用。
2000年至2014年间,所有脆性骨折住院的绝对数增加了30%,男性增加了40%,女性增加了27%。同期,骨质疏松性骨折的住院天数增加了51%。髋部骨折占住院人数的主导地位,占所有住院人数的36.5%,占所有住院天数的近一半(46.7%)。女性髋部骨折住院的年龄标准化率显著下降(p<0.001),但男性没有下降,而男性和女性非髋部骨质疏松性骨折住院率没有显著变化。预计到2046年,所有骨质疏松性骨折的住院人数将增加150%,达到31605人,其中58%将为80岁及以上。
在过去15年中,爱尔兰男性和女性的骨折住院人数显著增加。预计在未来三十年这一数字将进一步上升,这将给爱尔兰医疗系统带来巨大负担。