Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam, Republic of Korea.
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Gerontology. 2021;67(5):544-553. doi: 10.1159/000513730. Epub 2021 Mar 18.
Patients with Parkinson's disease (PD) are prone to falls, thereby increasing the risk of fractures and mortality. This population-based study investigated the risk of hip fractures and their effect on mortality in patients with PD in Korea.
National Health Insurance Service-National Sample Cohort data were used. Patients newly diagnosed with PD between 2006 and 2015 and age- and sex-matched individuals were classified into the PD group and the comparison group, respectively, with a 1:9 ratio. The Cox proportional hazards model was used to calculate hazard ratios (HRs), and the Kaplan-Meier method to identify survivorship.
In total, 26,570 individuals were enrolled in the study: 2,657 in the PD cohort and 23,913 in the matched comparison cohort. The PD group had about a 2 times higher risk of hip fracture than the comparison group (3.95 vs. 1.94%, p < 0.001). According to sex, the difference between the PD and comparison groups for the risk of hip fracture was greater in males than in females. The highest difference in HR for hip fracture between the PD and comparison groups was found in individuals aged between 60 and 69 years. Regarding post-fracture mortality in patients with PD, the mortality risk was twice as high in the patients with hip fracture than in those without. The effect of hip fracture on mortality between these 2 groups was also the highest in individuals aged between 60 and 69 years.
The PD group showed an approximately 2 times higher risk of hip fracture compared with the comparison group, and the post-fracture mortality rate was 2 times higher in the patients with PD with hip fracture than in those without. Those aged 60-69 years were associated with the highest risk of hip fracture and post-hip fracture mortality among patients with PD.
帕金森病（PD）患者容易发生跌倒，从而增加骨折和死亡的风险。本项基于人群的研究调查了韩国 PD 患者髋部骨折的风险及其对死亡率的影响。
使用国家健康保险服务-国家样本队列数据。将 2006 年至 2015 年间新诊断为 PD 的患者与年龄和性别相匹配的个体分别归入 PD 组和对照组，比例为 1:9。使用 Cox 比例风险模型计算风险比（HR），并采用 Kaplan-Meier 法确定生存率。
共有 26570 人纳入本研究：PD 队列 2657 人，匹配对照组 23913 人。PD 组髋部骨折的风险比对照组高约 2 倍（3.95%比 1.94%，p<0.001）。按性别分层，PD 组与对照组相比，男性髋部骨折的风险差异大于女性。PD 组与对照组之间髋部骨折的 HR 最高差异发生在 60-69 岁年龄组。关于 PD 患者髋部骨折后的死亡率，髋部骨折患者的死亡风险是无骨折患者的 2 倍。这两组之间髋部骨折对死亡率的影响在 60-69 岁年龄组也是最高的。
PD 组髋部骨折的风险比对照组高约 2 倍，且 PD 合并髋部骨折患者的骨折后死亡率是无骨折患者的 2 倍。60-69 岁年龄组 PD 患者发生髋部骨折和髋部骨折后死亡的风险最高。
