Department of Geriatric Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.
Clin Interv Aging. 2021 Jul 13;16:1337-1346. doi: 10.2147/CIA.S316739. eCollection 2021.
Limited information exists on fall-related fractures in older adults with cerebrovascular disease. This study aimed to determine the characteristics of older adults with cerebrovascular disease who sustained fall-related fractures and identify the associated risk factors for perioperative complications.
This was a cross-sectional study, which included patients with cerebrovascular disease who sustained fractures between Jan. 2017 and Dec. 2019. The collected data included demographics (age and gender), time and place of fracture occurrence, mechanism of injury, fracture location, type of cerebrovascular disease, complications, and comorbidities.
A total of 768 patients with 815 fractures were included; there were 253 males and 515 females, with an average age of 78.3 years. For either males or females, 80-84 years was the most commonly involved age group. Most (61.0%) patients had their fractures occurring at home and most fractures (70.7%) occurred during the daytime. Most were hip fractures and limb weakness; instability-related falls were the most common cause of fracture, making a proportion of 34.5%. Patients who suffered falls were mainly combining ischemic cerebrovascular disease. Most (85.9%) patients presented with at least one comorbid disease and the perioperative complication rate was 76.9% in total cases. Age≥80 (OR: 1.772, 95% CI: 1.236-2.540) and the number of comorbidities≥3 (OR: 1.606, 95% CI: 1.035-2.494) were found independently associated with complications, while the type of cerebrovascular disease, fracture location, and comorbidities of prior fragility fracture and respiratory disease were not significantly correlated with complications.
Our findings highlighted that more focus on improved physical function explored in intervention setting and the importance of primary home prevention measures seems justified in China and maybe other countries as well. It is the first study that presented the epidemiological characteristics of older adults with cerebrovascular disease who later experienced a fracture.
关于患有脑血管疾病的老年人与跌倒相关的骨折,相关信息有限。本研究旨在确定患有脑血管疾病且发生跌倒相关骨折的老年人的特征,并确定与围手术期并发症相关的危险因素。
这是一项横断面研究,纳入了 2017 年 1 月至 2019 年 12 月期间发生骨折的脑血管疾病患者。收集的数据包括人口统计学特征(年龄和性别)、骨折发生的时间和地点、损伤机制、骨折部位、脑血管疾病类型、并发症和合并症。
共纳入 768 例患者(815 处骨折),其中男性 253 例,女性 515 例,平均年龄为 78.3 岁。对于男性或女性而言,80-84 岁是最常见的年龄段。大多数(61.0%)患者的骨折发生在家里,大多数(70.7%)骨折发生在白天。大多数是髋部骨折和肢体无力;不稳定相关的跌倒则是最常见的骨折原因,占比为 34.5%。发生跌倒的患者主要合并缺血性脑血管病。大多数(85.9%)患者至少有一种合并症,总的围手术期并发症发生率为 76.9%。年龄≥80 岁(OR:1.772,95%CI:1.236-2.540)和合并症≥3 种(OR:1.606,95%CI:1.035-2.494)与并发症独立相关,而脑血管疾病类型、骨折部位以及先前脆性骨折和呼吸系统疾病的合并症与并发症无显著相关性。
本研究结果表明,在中国乃至其他国家,更注重干预措施中改善身体功能,以及重视家庭一级预防措施似乎是合理的。这是第一项研究脑血管疾病患者发生骨折后,呈现出老年人的流行病学特征的研究。