Ruckle David E, Dahan Alden, Jesurajan Jose, Nayak Rusheel, Rice R Casey, Wongworawat M Daniel, Johnson Joey P, Rajfer Rebecca
From the Department of Orthopedic Surgery, Loma Linda University Health, Loma Linda, CA (Ruckle, Jesurajan, Nayak, Rice, Wongworawat, and Rajfer), the Department of Anesthesiology, University of California San Diego, San Diego, CA (Dahan), Department of Orthopedic Surgery, University of Alabama Birmingham Medicine, Birmingham, Alabama (Johnson).
J Am Acad Orthop Surg. 2024 Oct 1;32(19):e1005-e1011. doi: 10.5435/JAAOS-D-23-00723. Epub 2024 May 29.
Hip fractures are life-changing injuries with associated one-year mortality up to 30%. Five locations in the world have been termed "blue zones," where the longevity of the population is markedly higher than that of surrounding areas and there are 10 times more centenarians. The United States has one blue zone (Loma Linda, California), which is believed to be because of the lifestyle of the Seventh-day Adventist population living there. We hypothesized that patients from the blue zone experience low-energy, frailty-driven, osteoporotic hip fractures later in life and an increased postinjury longevity relative to non-blue zone control subjects.
A review of patients treated for hip fracture between January 2010 and August 2020 from a single institution was conducted. Demographic data were collected, and the end point of mortality was assessed using death registry information, queried in April 2024. Groups were divided into blue zone and non-blue zone. Statistical analysis was conducted with P < 0.05 considered significant.
Complete data were available for 1,032 patients. The blue zone cohort sustained low-energy hip fractures 12 years later in life (83.2 versus 71.1, P < 0.01). Propensity score matching was used to account for this difference. After propensity score matching, age, body mass index, American Society of Anesthesiologists score, surgery performed, sex, mechanism, ethnicity, diabetes, chronic obstructive pulmonary disease, CHF, chronic kidney disease grade, dementia, surgical time, and drug/tobacco/marijuana use were similar between groups. Blue zone patients had lower mortality at both 1 and 2 years postoperatively (12% versus 24%, P = 0.03 and 20% versus 33%, P = 0.03, respectively), had more hypertension (76% versus 62%, P = 0.03), reported lower alcohol use (7% versus 20%, P < 0.01), and included more Seventh-day Adventists (64% versus 15%, P < 0.01).
The blue zone lifestyle affected the onset of frailty and delayed osteoporotic hip fracture by 12 years in this propensity-matched cohort study. Postoperative mortality was also markedly lower in the blue zone cohort.
髋部骨折是改变生活的损伤，相关的一年死亡率高达30%。世界上有五个地区被称为“蓝色地带”，那里人口的长寿程度明显高于周边地区，百岁老人的数量是其他地区的10倍。美国有一个蓝色地带（加利福尼亚州的洛马林达），据信这是由于生活在那里的基督复临安息日会人群的生活方式所致。我们假设，与非蓝色地带的对照受试者相比，来自蓝色地带的患者在晚年经历低能量、由身体虚弱驱动的骨质疏松性髋部骨折，且伤后的寿命会延长。
对2010年1月至2020年8月期间在一家机构接受髋部骨折治疗的患者进行回顾性研究。收集人口统计学数据，并使用2024年4月查询的死亡登记信息评估死亡率这一终点指标。将患者分为蓝色地带组和非蓝色地带组。进行统计分析，P < 0.05被视为具有统计学意义。
共有1032例患者获得了完整数据。蓝色地带队列的患者在12年后发生低能量髋部骨折（83.2岁对7
