Da Qingchen, Xiao Yingheng, Wu Feng, Chen Yueliang, Li Liping
School of Public Health, Shantou University, Shantou, 515041, China.
Injury Prevention Research Center, Shantou University Medical College, Shantou, 515041, China.
BMC Geriatr. 2024 Jun 12;24(1):514. doi: 10.1186/s12877-024-05122-x.
Wearing hip protectors is a measure used to prevent hip fractures caused by falls. However, its protective effect has remained controversial in previous studies. This study provides a rationale for the use of hip protectors by pooling all the current meta-analysis evidence.
We conducted an umbrella review of all the current meta-analysis articles about the efficacy of hip protectors to reduce hip fractures and falls in communities and/or institutions. Major databases including EMBASE, Cochrane Library, PubMed and Web of Science, were searched up to June 2022. Two reviewers screened the studies, extracted the data, and conducted the methodological quality assessment independently. The primary outcome was the association statistic (odds ratio (OR), relative risk (RR), etc.) reported in the meta-analysis that quantified the influence of the intervention on hip fractures and falls compared to that of the control group. Narrative synthesis was also conducted. Forest plots and the AMSTAR score were used to describe the results and quality of the pooled literature, respectively.
A total of six meta-analysis articles were included in the study. Hip protectors were effective at reducing hip fractures in older individuals who were in institutions (nursing or residential care settings) but not in communities (RR = 0.70, 95% CI 0.58 to 0.85, I = 42%, P < 0.001) (RR = 1.12, 95% CI 0.94 to 1.34, I = 0%, P = 0.20), and they did not reduce falls (RR = 1.01, 95% CI 0.90 to 1.13, I = 0%, P = 0.89).
Hip protectors are effective at preventing hip fractures in institutionalized older adults but not in community-dwelling older adults.
This study has been registered in PROSPERO (PROSPERO ID: CRD42022351773).
佩戴髋部保护器是预防跌倒所致髋部骨折的一项措施。然而，其保护效果在以往研究中一直存在争议。本研究通过汇总当前所有的荟萃分析证据，为髋部保护器的使用提供了理论依据。
我们对当前所有关于髋部保护器在社区和/或机构中减少髋部骨折及跌倒疗效的荟萃分析文章进行了一项综合性回顾。检索了包括EMBASE、Cochrane图书馆、PubMed和Web of Science在内的主要数据库，检索截至2022年6月。两名评审员筛选研究、提取数据并独立进行方法学质量评估。主要结局是荟萃分析中报告的关联统计量（比值比（OR）、相对危险度（RR）等），该统计量量化了与对照组相比干预措施对髋部骨折和跌倒的影响。还进行了叙述性综合分析。森林图和AMSTAR评分分别用于描述汇总文献的结果和质量。
本研究共纳入6篇荟萃分析文章。髋部保护器对机构（护理或居住护理机构）中的老年人预防髋部骨折有效，但对社区中的老年人无效（RR = 0.70，95%CI 0.58至0.85，I = 42%，P < .001）（RR = 1.12，95%CI 0.94至1.34，I = 0%，P = 0.20），且不能减少跌倒（RR = 1.01，95%CI 0.90至1.13，I = 0%，P = 0.89）。
髋部保护器对机构养老的老年人预防髋部骨折有效，但对社区居住的老年人无效。
本研究已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42022351773）。
