Chen Fang-Ping, Fu Tsai-Sheng, Lin Yu-Ching, Fan Chih-Ming
Department of Obstetrics and Gynecology, Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Keelung, Taiwan.
Department of Orthopaedic Surgery, Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Keelung, Taiwan.
J Obstet Gynaecol Res. 2018 Jun;44(6):1126-1133. doi: 10.1111/jog.13637. Epub 2018 Apr 11.
The aim of this study was to identify the correlation between health-related quality of life (HRQOL) and risk factors of first-incidence hip fracture in postmenopausal women.
This case-control study included 99 postmenopausal women with first-incident hip fracture and 101 women without hip fracture who were matched according to age. Evaluation consisted of clinical factors, 36-item Short-Form Health Survey (SF-36) and dual-energy X-ray absorptiometry for bone mineral density of hip and spine.
The mean age of patients with an accidental first-incident hip fracture was 78.0 years. Patients with hip fractures had significantly lower scores for SF-36 domains at enrollment and 4-month follow up compared with the controls. Mental health also deteriorated significantly 4 months after hip fracture. Aside from lower HRQOL, clinical factors, including increased body height, no experience with estrogen therapy, rheumatoid arthritis, use of walking aids, less weight-bearing exercise, and diuretics use, were significant risk factors for hip fracture in univariate analysis. After multivariate adjustment, only the use of walking aids and decreased physical component summary were independent risk factors of hip fracture. Besides aging, use of walking aids, weight-bearing exercise, and psychological medication were the main factors affecting HRQOL when considering their relationship with hip fractures.
The occurrence of first-incidence hip fracture is highly associated with HRQOL. Aside from aging, clinical factors affecting HRQOL correlated with hip fracture incidence. Thus, in elderly women, exercise or physical therapy to improve physical function and mental support is crucial and should be considered the most important factors for first-incidence hip fracture prevention.
本研究旨在确定绝经后女性健康相关生活质量（HRQOL）与首次发生髋部骨折的危险因素之间的相关性。
本病例对照研究纳入了99例首次发生髋部骨折的绝经后女性和101例无髋部骨折的女性，后者根据年龄进行匹配。评估内容包括临床因素、36项简明健康调查问卷（SF-36）以及髋部和脊柱骨密度的双能X线吸收测定法。
首次意外发生髋部骨折患者的平均年龄为78.0岁。与对照组相比，髋部骨折患者在入组时和4个月随访时SF-36各领域得分显著更低。髋部骨折4个月后心理健康状况也显著恶化。在单因素分析中，除了HRQOL较低外，临床因素包括身高增加、未接受过雌激素治疗、类风湿关节炎、使用助行器、负重锻炼较少以及使用利尿剂均是髋部骨折的显著危险因素。多因素调整后，仅使用助行器和身体成分综合评分降低是髋部骨折的独立危险因素。除衰老外，考虑到与髋部骨折的关系，使用助行器、负重锻炼和心理药物是影响HRQOL的主要因素。
首次发生髋部骨折的发生与HRQOL高度相关。除衰老外，影响HRQOL的临床因素与髋部骨折发生率相关。因此，对于老年女性，进行锻炼或物理治疗以改善身体功能和给予心理支持至关重要，应被视为预防首次发生髋部骨折的最重要因素。
