CHU Lille, Geriatrics department, F-59000, Lille, France.
Univ. Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France.
Osteoporos Int. 2020 Jul;31(7):1353-1360. doi: 10.1007/s00198-020-05363-7. Epub 2020 Mar 5.
We investigated the association between hip fracture incidence and living area characteristics in France. The spatial distribution of hip fracture incidence was heterogeneous and there was a significant relationship between social deprivation, urbanization, health access, and hip fracture risk.
Several studies have shown great disparities in spatial repartition of hip fractures (HF). The aim of the study was to analyze the association between HF incidence and characteristics of the living area.
All patients aged 50 or older, living in France, who were hospitalized for HF between 2012 and 2014 were included, using the French national hospital discharge database. Standardized incidence ratio (SIR) was calculated for each spatial unit and adjusted on age and sex. An ecological regression was performed to analyze the association between HF standardized incidence and ecological variables. We adjusted the model for neighborhood spatial structure. We used three variables to characterize the living areas: a deprivation index (French-EDI); healthcare access (French standardized index); land use (percentage of artificialized surfaces).
A total of 236,328 HF were recorded in the French hospital national database, leading to an annual HF incidence of 333/100,000. The spatial analysis revealed geographical variations of HF incidence with SIR varying from 0.67 (0.52; 0.85) to 1.45 (1.23; 1.70). There was a significant association between HF incidence rates and (1) French-EDI (trend p = 0.0023); (2) general practitioner and nurse accessibility (trend p = 0.0232 and p = 0.0129, respectively); (3) percentage of artificialized surfaces (p < 0.0001).
The characteristics of the living area are associated with significant differences in the risk of hip fracture of older people.
研究法国髋部骨折发生率与居住区域特征之间的关系。方法：使用法国国家医院出院数据库，纳入 2012 年至 2014 年期间因髋部骨折住院的所有年龄在 50 岁及以上的患者。为每个空间单位计算标准化发病比（SIR），并根据年龄和性别进行调整。采用生态回归分析 SIR 与生态变量之间的关系。我们调整模型以考虑邻里空间结构。我们使用三个变量来描述居住区域：剥夺指数（French-EDI）；医疗保健可及性（法国标准化指数）；土地利用（人工化表面百分比）。结果：法国国家医院数据库共记录 236328 例髋部骨折，导致年发病率为 333/100000。空间分析显示髋部骨折发生率存在地理差异，SIR 从 0.67（0.52；0.85）到 1.45（1.23；1.70）不等。髋部骨折发生率与（1）French-EDI（趋势 p=0.0023）；（2）全科医生和护士的可及性（趋势 p=0.0232 和 p=0.0129）；（3）人工化表面百分比（p<0.0001）显著相关。结论：居住区域的特征与老年人髋部骨折风险的显著差异相关。
