The University of Chicago Pritzker School of Medicine, Chicago, IL; and.
Department of Orthopaedics, The University of Chicago Medicine, Chicago, IL.
J Orthop Trauma. 2022 Oct 1;36(10):519-524. doi: 10.1097/BOT.0000000000002378.
Use a large database design and multivariable analyses to assess the associations between body mass index (BMI) and femur fracture patterns after controlling for other risk factors.
Retrospective cohort study.
National insurance claims database of patient records from 2010 to 2018.
PATIENTS/PARTICIPANTS: Patients with femur fracture diagnoses were identified. Patients with multiple fractures within 1 week (polytrauma patients), patients without a BMI diagnosis code within 6 months of fracture, and patients with multiple BMI diagnosis codes (implying a substantial change in weight) were excluded.
N/A.
Patients were divided into groups based on fracture location: proximal (OTA/AO 31), shaft (OTA/AO 32), or distal (OTA/AO 33). The distribution of femur fractures was compared across BMI categories.
A total of 57,042 patients with femur fracture were identified: 45,586 proximal fractures, 4216 shaft fractures, and 7240 distal fractures. Patients with BMI <29.9 have increased odds ( P < 0.0001) of proximal fracture and decreased odds ( P < 0.0001) of shaft or distal fractures. Patients with BMI >30.0 have decreased odds ( P < 0.0001) of proximal fracture and increased odds ( P < 0.0001) of distal fractures.
Increasing BMI is associated with a decreased proportion of proximal femur fractures and a corresponding increase in the proportion of shaft and distal fractures. Regression analyses determined that age, sex, osteoporosis, diabetes, and tobacco use are not the cause of this trend.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
利用大型数据库设计和多变量分析，在控制其他风险因素的情况下，评估体重指数（BMI）与股骨骨折类型之间的关系。
回顾性队列研究。
2010 年至 2018 年的国家保险索赔数据库，包含患者病历记录。
患者/参与者：确定了股骨骨折诊断的患者。排除了在 1 周内有多处骨折（多发创伤患者）、骨折后 6 个月内无 BMI 诊断代码以及有多个 BMI 诊断代码（暗示体重发生了实质性变化）的患者。
无。
根据骨折部位将患者分为以下几组：近端（OTA/AO 31）、骨干（OTA/AO 32）或远端（OTA/AO 33）。比较 BMI 类别之间的股骨骨折分布情况。
共确定了 57042 例股骨骨折患者：45586 例近端骨折，4216 例骨干骨折，7240 例远端骨折。BMI <29.9 的患者发生近端骨折的可能性增加（P <0.0001），发生骨干或远端骨折的可能性降低（P <0.0001）。BMI >30.0 的患者发生近端骨折的可能性降低（P <0.0001），发生远端骨折的可能性增加（P <0.0001）。
BMI 的增加与近端股骨骨折比例的降低以及骨干和远端骨折比例的相应增加有关。回归分析确定年龄、性别、骨质疏松症、糖尿病和吸烟不是造成这种趋势的原因。
预后 III 级。有关证据水平的完整描述，请参见作者说明。
