老年骨质疏松性骨盆骨折患者一年死亡率。

The one-year mortality rate in elderly patients with osteoporotic fractures of the pelvis.

机构信息

Clinic of Rheumatology, Orthopaedics Traumatology and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Centre of Orthopaedics and Traumatology, Republican Vilnius University Hospital, Šiltnamių str. 29, LT-04130, Vilnius, Lithuania.

出版信息

Arch Osteoporos. 2020 Feb 20;15(1):15. doi: 10.1007/s11657-020-0689-8.

DOI:10.1007/s11657-020-0689-8

PMID:32078053

Abstract

UNLABELLED

Osteoporosis is a common condition for elderly people. The incidence of osteoporotic pelvic fractures has been increasing. Osteoporotic pelvic fractures are associated with increased mortality rates. Based on the aim of our study, we found out that one-year mortality rate after a pelvic fracture is high and depends on the fracture type.

PURPOSE

The aim of this study was to determine the one-year mortality rate in patients aged 65+ with osteoporotic pelvic fractures depending on the type of fracture according to AO/OTA classification.

METHODS

Patients aged 65+ with pelvic insufficiency fractures admitted to a single center between 1 June 2013 and 31 December 2016 were enrolled in the study. The fractures were classified according to AO/OTA classification. The start of the survival time analysis was the date of the injury. The end of the analysis was 31 December 2017 or the date of the patient's death. Mortality rates were assessed with respect to fracture types using Kaplan-Meier curves. The Cox proportional hazards model was applied to assess the dependence of mortality on the fracture type.

RESULTS

A total of 105 patients with 95 (90.5%) being female were enrolled in this prospective study. The average age was 80.3 years (95% CI 78.8-81.7). Mean follow-up time was 23.5 months (95% CI 20.7-26.4). According to AO/OTA classification, 30 (28.6%) patients had a type A pelvic fracture, 73 (69.5%) patients-type B fracture, and 2 (1.9%)-type C fracture. Overall, the one-year mortality rate was 23.8% (95% CI 16.8-33.2%). For patients with type A fracture, the one-year mortality rate was 13.3% (95% CI 5.2-31.7%) compared with 27.4% (95% CI 18.6-39.2%) in the group with type B fracture, and this difference was statistically significant (p < 0.001).

CONCLUSIONS

We found that within a year after an osteoporotic pelvic fracture, the number of deaths in the patients having type B pelvic fracture was twice higher than in the patients with type A fracture.

摘要

目的

本研究旨在根据 AO/OTA 分类确定 65 岁以上骨质疏松性骨盆骨折患者的一年死亡率，根据骨折类型。

方法

研究纳入 2013 年 6 月 1 日至 2016 年 12 月 31 日期间在一家中心因骨盆不稳定性骨折入院的 65 岁以上患者。骨折根据 AO/OTA 分类进行分类。生存时间分析的开始日期为受伤日期。分析结束日期为 2017 年 12 月 31 日或患者死亡日期。使用 Kaplan-Meier 曲线根据骨折类型评估死亡率。应用 Cox 比例风险模型评估死亡率与骨折类型的相关性。

结果

本前瞻性研究共纳入 105 例患者，其中 95 例（90.5%）为女性。平均年龄为 80.3 岁（95%CI 78.8-81.7）。平均随访时间为 23.5 个月（95%CI 20.7-26.4）。根据 AO/OTA 分类，30 例（28.6%）患者为 A 型骨盆骨折，73 例（69.5%）患者为 B 型骨折，2 例（1.9%）为 C 型骨折。总体而言，一年死亡率为 23.8%（95%CI 16.8-33.2%）。对于 A 型骨折患者，一年死亡率为 13.3%（95%CI 5.2-31.7%），而 B 型骨折患者的一年死亡率为 27.4%（95%CI 18.6-39.2%），差异具有统计学意义（p<0.001）。