Montoya-García Maria-José, Giner Mercè, Marcos Rodrigo, García-Romero David, Olmo-Montes Francisco-Jesús, Miranda Mª José, Hernández-Cruz Blanca, Colmenero Miguel-Angel, Vázquez-Gámez Mª Angeles
Departamento de Medicina, Universidad de Sevilla, Avda. Dr. Fedriani s/n, 41009 Sevilla, Spain.
Departamento de Citología e Histología Normal y Patológica, Universidad de Sevilla, Avda. Dr. Fedriani s/n, 41009 Sevilla, Spain.
J Clin Med. 2021 Mar 5;10(5):1082. doi: 10.3390/jcm10051082.
Fragility fractures constitute a major public health problem worldwide, causing important high morbidity and mortality rates. The aim was to present the epidemiology of fragility fractures and to assess the imminent risk of a subsequent fracture and mortality. This is a retrospective population-based cohort study (n = 1369) with a fragility fracture. We estimated the incidence rate of index fragility fractures and obtained information on the subsequent fractures and death during a follow-up of up to three years. We assessed the effect of age, sex, and skeletal site of index fracture as independent risk factors of further fractures and mortality. Incidence rate of index fragility fractures was 86.9/10,000 person-years, with highest rates for hip fractures in women aged ≥80 years. The risk of fracture was higher in subjects with a recent fracture (Relative Risk(RR), 1.80; < 0.01). Higher age was an independent risk factor for further fracture events. Significant excess mortality was found in subjects aged ≥80 years and with a previous hip fracture (hazard ratio, 3.43 and 2.48, respectively). It is the first study in Spain to evaluate the incidence of major osteoporotic fractures, not only of the hip, and the rate of imminent fracture. Our results provide further evidence highlighting the need for early treatment.
脆性骨折是全球范围内的一个主要公共卫生问题，导致了重要的高发病率和死亡率。目的是介绍脆性骨折的流行病学情况，并评估后续骨折和死亡的近期风险。这是一项基于人群的回顾性队列研究（n = 1369），研究对象为脆性骨折患者。我们估计了初次脆性骨折的发病率，并获取了长达三年随访期间后续骨折和死亡的信息。我们评估了年龄、性别和初次骨折的骨骼部位作为进一步骨折和死亡的独立危险因素的影响。初次脆性骨折的发病率为86.9/10000人年，≥80岁女性的髋部骨折发病率最高。近期有骨折的受试者发生骨折的风险更高（相对风险（RR），1.80；P < 0.01）。高龄是进一步发生骨折事件的独立危险因素。在≥80岁且既往有髋部骨折的受试者中发现了显著的超额死亡率（风险比分别为3.43和2.48）。这是西班牙第一项评估主要骨质疏松性骨折（不仅是髋部骨折）的发病率以及近期骨折发生率的研究。我们的结果提供了进一步的证据，强调了早期治疗的必要性。
