Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Department of Internal medicine, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Republic of Korea.
Arch Osteoporos. 2020 Oct 20;15(1):165. doi: 10.1007/s11657-020-00820-6.
In this study, the risk of fatality after hip fracture but not the risk of subsequent hip fractures was higher among men.
The purpose of this study was to analyze the risk factors for subsequent hip fractures and fatality after an initial hip fracture among Koreans older than 50 years of age using information in the national claims database.
Our study was conducted using data from the Korean National Health Insurance Service database from 2007 to 2016. A total of 16,915 Korean patients aged ≥ 50 years with a first hip fracture in 2012 were followed for 4 years. Data on fracture, comorbidity, and prescription variables were retrieved from the national registry. The Cox proportional hazards model was used to identify the risk factors affecting subsequent hip fractures and fatality after the initial hip fracture.
A total of 952 patients had subsequent hip fractures, and 6793 patients died. The cumulative incidence rates were 1.3% after 1 year and 5.6% after 4 years. Old age, renal disease, dementia, and Parkinson's disease were associated with a higher risk of subsequent hip fractures. The fatality rate after the initial hip fracture was 1.6 times higher among men than among women. Certain risk factors for fatality, such as pneumonia after fracture, cerebrovascular disease, mild liver disease, renal disease, and malignancy, were more prevalent among men.
During the study period, the risk of fatality after hip fracture but not the risk of subsequent hip fractures was higher among men. The gender difference in fatality might be explained by the larger burden of comorbid diseases among men.
本研究中，男性髋部骨折后死亡风险高于女性，但髋部骨折后再发风险则无性别差异。
本研究旨在利用国家理赔数据库中的信息，分析韩国≥50 岁人群初次髋部骨折后再发髋部骨折和死亡的风险因素。
我们的研究使用了 2007 年至 2016 年韩国国家健康保险服务数据库的数据。共纳入 16915 例 2012 年初次髋部骨折、年龄≥50 岁的韩国患者，随访 4 年。骨折、合并症和处方变量的数据从国家登记处获取。采用 Cox 比例风险模型确定影响初次髋部骨折后再发髋部骨折和死亡的风险因素。
共有 952 例患者发生再发髋部骨折，6793 例患者死亡。1 年和 4 年的累积发生率分别为 1.3%和 5.6%。高龄、肾脏疾病、痴呆和帕金森病与再发髋部骨折风险增加相关。与女性相比，男性初次髋部骨折后死亡率更高（1.6 倍）。某些与死亡相关的风险因素，如骨折后肺炎、脑血管病、轻度肝病、肾脏疾病和恶性肿瘤，在男性中更为常见。
在研究期间，男性髋部骨折后死亡风险高于女性，但髋部骨折后再发风险则无性别差异。男性死亡率的性别差异可能是由合并症负担更大所致。
