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股骨近端骨折对侧骨折的流行病学和危险因素:一项 1022 例患者的单中心回顾性队列研究。

Epidemiology and risk factors for contralateral proximal femur fracture: a single center retrospective cohort study on 1022 patients.

机构信息

Orthopaedics and Traumatology Unit, Cattinara Hospital - ASUITS, Strada di Fiume 447, 34149 Trieste (Italy).

Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste (Italy).

出版信息

Acta Biomed. 2020 May 30;91(4-S):115-121. doi: 10.23750/abm.v91i4-S.9716.

Abstract

UNLABELLED

Summary.

BACKGROUND AND AIM OF THE WORK

Given the high impact of proximal femur fractures (PFFs) on elderly patients and healthcare systems, the burden of contralateral PFFs might be overlooked. Aim of the study is to analyze the epidemiology and risk factors of contralateral proximal femur fractures. Secondary aim is to detect mortality rate differences in first and contralateral PPF.

METHODS

A population of 1022 patients admitted for proximal femur fractures in a single center was studied. Prevalence at admission as well as incidence of contralateral PFF during a 18 to 36 months follow-up was recorded. Epidemiology of contralateral PFF was studied recording number of events, time to second fracture and fracture type. Mortality at 1-year was recorded for all patients and compared between first and second PFF patients. Comorbidities, pharmacotherapy, BMI, MNA and SPMSQ were studied as possible risk factors.

RESULTS

Prevalence and incidence of contralateral PFFs were 9.4% and 6.5% respectively. Median time to second fracture was 12 months. One-year mortality of contralateral PFFs was significantly lower (20.5% vs 25.1%, p 0.003) than first PFF. Contralateral fracture patients had a significantly lower BMI and a significantly lower proportion of malnourished patients.

CONCLUSIONS

The incidence and prevalence of contralateral PFFs is relevant. Mortality of contralateral PFFs results to be lower than first PFF. Patients with higher BMI and malnourished patients have a lower risk of contralateral PFF.

摘要

目的

本研究旨在分析股骨近端骨折(PFF)的流行病学及危险因素,以及初次和对侧 PFF 之间的死亡率差异。

方法

研究纳入了在单中心接受股骨近端骨折治疗的 1022 名患者。记录入院时的患病率以及 18-36 个月随访期间对侧 PFF 的发生率。记录对侧 PFF 的发病数量、第二次骨折的时间和骨折类型,研究其流行病学特征。记录所有患者的 1 年死亡率,并比较初次和再次 PFF 患者的死亡率。研究了合并症、药物治疗、BMI、MNA 和 SPMSQ 等可能的危险因素。

结果

对侧 PFF 的患病率和发生率分别为 9.4%和 6.5%。第二次骨折的中位时间为 12 个月。对侧 PFF 的 1 年死亡率明显低于初次 PFF(20.5%比 25.1%,p<0.003)。对侧骨折患者的 BMI 明显较低,营养不良患者的比例也明显较低。

结论

对侧 PFF 的发生率和患病率较高。对侧 PFF 的死亡率低于初次 PFF。BMI 较高和营养不良的患者发生对侧 PFF 的风险较低。

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