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新冠疫情公共卫生限制对与跌倒相关的髋部骨折住院的影响:一项中断时间序列分析。

Impact of COVID-19 public health restrictions on fall-related hip fracture hospitalizations: An interrupted time series analysis.

机构信息

Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, NSW 2109, Australia; Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.

Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, NSW 2109, Australia.

出版信息

Bone. 2024 Nov;188:117237. doi: 10.1016/j.bone.2024.117237. Epub 2024 Aug 17.

Abstract

PURPOSE

There is limited evidence regarding the impact of public health restrictions on hip fracture hospitalization by place of fracture occurrence. This study aimed to examine the impact of COVID-19 public health restrictions on fall-related hip fracture hospitalization rates by place of occurrence.

METHODS

This retrospective cohort study was conducted using hospitalization data in New South Wales, Australia, between January 2014 and June 2022. Older adults aged ≥65 years admitted to hospital following a fall-related hip fracture. An interrupted time-series analysis using autoregressive integrated moving average models evaluated the impact of public health restrictions on fall-related hip fracture hospitalization by place of fracture occurrence (home/residence, residential aged care facility (RACF), or away from usual residence).

RESULTS

The mean observed fall-related hip fracture hospitalization rate during COVID-19 public health restrictions (36.3 per 100,000 people per month) was 13.4 % lower than the forecasted rate (41.1 per 100,000 people per month). The mean observed hospitalization rates for fall-related hip fractures at home/residence, at a RACF, and away from the usual residence were 3.8 %, 18.5 %, and 40.1 % lower than the forecasted rates, respectively. Level changes in the fall-related hip fracture hospitalization rates at RACFs and away from usual residences were -0.9 per 100,000 people per month (95 % CI -1.6 to -0.2) and -1.7 per 100,000 people per month (95 % CI -2.5 to -0.9), respectively.

CONCLUSIONS

There was a decline in fall-related hip fracture hospitalization rates among older adults, where the fracture occurred at RACFs and away from a person's usual residence during COVID-19 public health restrictions.

摘要

目的

关于公共卫生限制对骨折发生地点的髋部骨折住院的影响,证据有限。本研究旨在检查 COVID-19 公共卫生限制对发生地点的跌倒相关髋部骨折住院率的影响。

方法

这是一项回顾性队列研究,使用澳大利亚新南威尔士州 2014 年 1 月至 2022 年 6 月期间的住院数据。年龄在 65 岁及以上的老年人因跌倒相关髋部骨折入院。使用自回归综合移动平均模型的中断时间序列分析评估了公共卫生限制对跌倒相关髋部骨折住院的影响,骨折发生地点(家庭/住所、养老院或住所之外)。

结果

COVID-19 公共卫生限制期间观察到的跌倒相关髋部骨折住院率(每月每 10 万人 36.3 人)比预测率(每月每 10 万人 41.1 人)低 13.4%。家庭/住所、养老院和住所之外跌倒相关髋部骨折的观察住院率分别比预测率低 3.8%、18.5%和 40.1%。养老院和住所之外跌倒相关髋部骨折住院率的水平变化分别为每月每 10 万人 -0.9(95%CI-1.6 至-0.2)和 -1.7(95%CI-2.5 至-0.9)。

结论

在 COVID-19 公共卫生限制期间,养老院和住所之外跌倒相关髋部骨折的住院率下降,老年人在此类地点发生骨折。

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