Lin Kai-Biao, Yang Nan-Ping, Lee Yi-Hui, Chan Chien-Lung, Wu Chi-Hsu, Chen Hou-Chuan, Chang Nien-Tzu
School of Computer & Information Engineering, Xiamen University of Technology, Xiamen, China.
Department of Information Management, Yuan Ze University, Taoyuan, Taiwan.
PLoS One. 2018 Feb 15;13(2):e0192388. doi: 10.1371/journal.pone.0192388. eCollection 2018.
Hip fractures are a major problem to elder population, but subsequent morbidity is unclear about environmental factors and socioeconomic conditions. The study aims to investigate the incidence of hip fractures treated by the surgery; to compare the sequelae and temporal trends of hip fractures; to evaluate the seasonal effects in the subsequent short-term and long-term morbidities after hip fractures. A cohort study design is conducted using national health research datasets between 2000 and 2010. The ICD-9-CM diagnostic codes were utilized to investigate the incidence of hip fractures and the corresponding treatments. Hierarchical modeling was used to analyze the factors associated with various types of hip fractures. The results indicated that females had a lower incidence in the 30-44 age group, but a significantly higher incidence than males among those aged 60 years or older (adjusted rates 232.1 vs. 100.3 per 100,000 persons, p<0.001). The incidence of hip fractures in the low-income group showed no significant difference compared to that in the general population. There was a temporal trend of a 8.6% increase in the incidence of all types of hip fractures over the period of 2000-2010. A summer-winter variation is observed among the elderly. Hip fractures and subsequent morbidity are increasing in Taiwan's aging society. Older age, female gender, and time periods were independent risk factors for subsequent morbidities after surgical treatment. The result of this study is useful to the healthcare policy makers and to raise the public awareness of hip fractures.
髋部骨折是老年人群面临的一个主要问题，但关于环境因素和社会经济状况对其后续发病率的影响尚不清楚。本研究旨在调查接受手术治疗的髋部骨折的发病率；比较髋部骨折的后遗症和时间趋势；评估髋部骨折后短期和长期发病情况中的季节效应。采用队列研究设计，使用2000年至2010年的国家卫生研究数据集。利用国际疾病分类第九版临床修正本（ICD-9-CM）诊断编码来调查髋部骨折的发病率及相应治疗情况。采用分层模型分析与各类髋部骨折相关的因素。结果表明，女性在30 - 44岁年龄组的发病率较低，但在60岁及以上人群中，其发病率显著高于男性（调整率分别为每10万人232.1例和100.3例，p<0.001）。低收入组髋部骨折的发病率与普通人群相比无显著差异。在2000 - 2010年期间，各类髋部骨折的发病率呈现出8.6%的时间趋势增长。在老年人中观察到了夏季和冬季的差异。在台湾老龄化社会中，髋部骨折及其后续发病率正在上升。年龄较大、女性性别和时间段是手术治疗后后续发病的独立危险因素。本研究结果对医疗保健政策制定者有用，也有助于提高公众对髋部骨折的认识。
