Barahona Maximiliano, Martinez Alvaro, Barrientos Cristian, Barahona Macarena A, Cavada Gabriel, Brañes Julian
Orthopaedic Department, Hospital Clinico Universidad De Chile, Santiago, CHL.
Orthopaedic Department, Hospital San Jose, Santiago, CHL.
Cureus. 2020 Nov 29;12(11):e11773. doi: 10.7759/cureus.11773.
Purpose The purpose of the study is to compare the survival after hip fracture in patients older than 50 years after hip fracture between a private and a public health center in Chile. We hypothesize that treatment at a private health center (PRH) may be associated with lower one-year mortality and longer median survival time after hip fracture (adjusted by gender and age) compared to a public health center (PLH). Methods PRH and PLH patients who were coded with a diagnosis of hip fracture were included in this study. PRH patients were included between 2002 to 2018, and PLH patients were included from 2012 to 2018. One-year mortality was estimated by logistic regression; meanwhile, median survival time was estimated by exponential regression. A survival analysis study was designed and approved by our institutional ethics review board. Results A total of 2130 patients were included in the PLH cohort, and a total of 1110 patients were included in the PRH. The one-year mean mortality, adjusted by age and gender, was 0.23 (range: 0.21 to 0.25) in the PLH and 0.16 (range: 0.13 to 0.18) in the PRH cohort. The median survival time, adjusted by age and gender, was 4.2 years (range: 4.1 to 4.4) in the PLH and 6.8 years (range: 6.3 to 7.29) in the PRH cohort. Conclusion Patients older than 50 years treated in a private health center have a higher median survival time and a lower probability of dying one year after a hip fracture.
目的 本研究旨在比较智利一家私立和一家公立医疗中心中50岁以上髋部骨折患者髋部骨折后的生存率。我们假设，与公立医疗中心（PLH）相比，在私立医疗中心（PRH）接受治疗的患者髋部骨折后一年死亡率可能更低，中位生存时间更长（根据性别和年龄调整）。方法 本研究纳入了诊断编码为髋部骨折的PRH和PLH患者。PRH患者纳入时间为2002年至2018年，PLH患者纳入时间为2012年至2018年。通过逻辑回归估计一年死亡率；同时，通过指数回归估计中位生存时间。本生存分析研究已由我们机构的伦理审查委员会设计并批准。结果 PLH队列共纳入2130例患者，PRH队列共纳入1110例患者。经年龄和性别调整后，PLH队列的一年平均死亡率为0.23（范围：0.21至0.25），PRH队列的一年平均死亡率为0.16（范围：0.13至0.18）。经年龄和性别调整后，PLH队列的中位生存时间为4.2年（范围：4.1至4.4），PRH队列的中位生存时间为6.8年（范围：6.3至7.29）。结论 在私立医疗中心接受治疗的50岁以上患者髋部骨折后中位生存时间更长，一年后死亡概率更低。
