Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.
Warwick Medical School, University of Warwick, Coventry, UK.
Bone Joint J. 2019 Jun;101-B(6):708-714. doi: 10.1302/0301-620X.101B6.BJJ-2018-1623.R1.
This study sought to determine the proportion of older adults with hip fractures captured by a multicentre prospective cohort, the World Hip Trauma Evaluation (WHiTE), whether there was evidence of selection bias during WHiTE recruitment, and the extent to which the WHiTE cohort is representative of the broader population of older adults with hip fractures.
The characteristics of patients recruited into the WHiTE cohort study were compared with those treated at WHiTE hospitals during the same timeframe and submitted to the National Hip Fracture Database (NHFD).
Patients recruited to WHiTE were more likely to be admitted from their own home (83.5% 80.2%; p < 0.001) and to have a higher median Abbreviated Mental Test Score (AMTS) (9 (interquartile range (IQR) 6 to 10) 9 (IQR 5 to 10); p < 0.001) than those who were not recruited. In terms of WHiTE cohort generalizability, participating hospitals included a greater proportion of Major Trauma Centres (47.8% 7.8%) and large hospitals (997 (IQR 873 to 1290) 707 (459 to 903) beds) with high-volume Emergency Departments (median annual attendances of 43 981 (IQR 37 147 to 54 385) 35 964 (IQR 26 229 to 50 551)). However, there were few differences in baseline characteristics between patients in the WHiTE cohort and those recorded in the NHFD.
There is evidence of a weak selection bias towards recruiting fitter patients within the WHiTE cohort, which will help to put into context the findings of future studies. We conclude that the patients within the WHiTE cohort are representative of the national population of older adults with hip fractures throughout England, Wales, and Northern Ireland. Cite this article: 2019;101-B:708-714.
本研究旨在确定多中心前瞻性队列研究（世界髋部创伤评估，WHiTE）中髋部骨折老年患者的比例，评估 WHiTE 招募过程中是否存在选择偏倚，以及 WHiTE 队列在多大程度上能够代表更广泛的髋部骨折老年人群。
比较 WHiTE 队列研究中招募的患者与同期在 WHiTE 医院接受治疗并纳入国家髋部骨折数据库（NHFD）的患者的特征。
WHiTE 招募的患者更有可能从自家（83.5%比 80.2%；p<0.001）入院，且简明精神状态测试（AMTS）中位数更高[9（四分位距（IQR）6 至 10）比 9（IQR 5 至 10）；p<0.001]。就 WHiTE 队列的可推广性而言，参与的医院包括更多的主要创伤中心（47.8%比 7.8%）和大医院（997（IQR 873 至 1290）比 707（459 至 903）张床位），且急诊部有大量就诊者（中位数每年就诊人数分别为 43981（IQR 37147 至 54385）比 35964（IQR 26229 至 50551））。然而，WHiTE 队列患者与 NHFD 记录患者的基线特征差异不大。
WHiTE 队列中存在对更健康患者进行选择性招募的微弱偏倚，这将有助于对未来研究结果进行背景分析。我们的结论是，WHiTE 队列中的患者能够代表英格兰、威尔士和北爱尔兰全国髋部骨折老年人群。
Bone Joint J. 2019;101-B(9):1131-1138.
