跌倒后髋部骨折患者的特征：NOREPOS 研究。

Characteristics of fallers who later sustain a hip fracture: a NOREPOS study.

机构信息

Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway.

Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.

出版信息

Osteoporos Int. 2022 Nov;33(11):2315-2326. doi: 10.1007/s00198-022-06490-z. Epub 2022 Aug 4.

DOI:10.1007/s00198-022-06490-z

PMID:35927464

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9568442/

Abstract

UNLABELLED

Fall prevention programs have shown inconclusive results concerning hip fracture reduction. We found that fallers with poor health, low societal participation, and use of psychotropics/painkillers had a threefold to fivefold increased hip fracture risk compared to non-fallers without these risk factors. This may help target fall prevention towards high-risk individuals.

INTRODUCTION

To investigate whether self-reported information on health, societal participation, and drug use in older people, easily obtainable by health care providers, contribute to predict future hip fracture beyond self-reported falls.

METHODS

We used data from 3801 women and 6439 men aged 70-79 years participating in population-based studies in five counties in Norway 2000-2003. Height and weight were measured. Socioeconomic status, lifestyle, health status, and history of falling were self-reported through questionnaires. Falls last year were dichotomized into one or more versus no falls. Hip fractures were identified by linkage to hospital data with follow-up through 2013. Hazard ratios (HR) with 95% confidence intervals (95% CI) for hip fracture by combinations of risk factors with history of falling were estimated using Cox proportional hazards regression.

RESULTS

More women (32.4%) than men (27.7%) reported one or more falls during the previous year, and 17.9% of women (n = 682) and 8.9% of men (n = 572) suffered a hip fracture during median 11.6 years of follow-up. Poor health, low societal participation, and use of psychotropics/analgesics among fallers were strong predictors of hip fracture. The presence of all three risk factors and history of falling was associated with HR 2.92 (95% CI 2.10-4.05) for hip fracture in women and HR 4.60 (95% CI 2.71-7.81) in men compared to non-fallers without these factors.

CONCLUSION

Our study indicates that self-assessment of health, information about activities outside home, and drug use among fallers far better identify high risk of hip fracture in older people than information about falls alone.

摘要

目的

调查老年人健康、社会参与和药物使用等自我报告信息是否有助于预测未来髋部骨折，这些信息可由医疗保健提供者轻易获得，且可补充自我报告的跌倒情况。

方法

我们使用了来自挪威五个县的 3801 名女性和 6439 名男性的年龄在 70-79 岁的数据，这些人参加了 2000-2003 年的五项基于人群的研究。身高和体重通过问卷进行测量。社会经济状况、生活方式、健康状况和跌倒史通过问卷调查获得。去年的跌倒情况分为有一次或多次跌倒和无跌倒两种情况。通过与医院数据的链接，并通过 2013 年的随访，确定了髋部骨折。使用 Cox 比例风险回归估计了具有跌倒史的危险因素组合与髋部骨折风险的风险比（HR）及其 95%置信区间（95%CI）。

结果

更多的女性（32.4%）报告在过去一年中有一次或多次跌倒，而女性（n=682）中有 17.9%和男性（n=572）中有 8.9%发生了髋部骨折，随访中位数为 11.6 年。跌倒者的健康状况不佳、社会参与度低和使用精神药物/镇痛药是髋部骨折的强预测因素。存在所有三个危险因素和跌倒史的女性髋部骨折风险比（HR）为 2.92（95%CI 2.10-4.05），男性为 4.60（95%CI 2.71-7.81），与无这些因素的非跌倒者相比。