Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, 30 E. Apple St. Suite #2200, Dayton, OH 45409-2932, United States.
Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, 30 E. Apple St. Suite #2200, Dayton, OH 45409-2932, United States.
Injury. 2024 Nov;55(11):111837. doi: 10.1016/j.injury.2024.111837. Epub 2024 Aug 23.
Fractures of the lower trunk are among the most common fractures occurring in the elderly. Super elderly individuals (i.e., those 80 years of age and older) represent a growing segment of the population and are especially prone to these fractures. The contemporary epidemiology of lower trunk fractures in the super elderly population is incompletely described in the literature.
This descriptive epidemiology study used the National Electronic Injury Surveillance System (NEISS) to examine the incidence and recent trends of lower trunk fractures (i.e., fractures of the hip, pelvis, and lumbar spine) occurring among super elderly individuals in the United States (US) from 2011 to 2020. Annual, overall, and age-/sex-specific incidence rates (IRs) were analyzed. Average annual percent change (AAPC) estimates were calculated to indicate the magnitude/direction of trends in annual injury rates.
An estimated N=1,226,160 super elderly patients sustained lower trunk fractures over the 10-year study period for an overall IR of 100.2 per 10,000 person-years at-risk (PYR). Hip fractures accounted for the largest percentage of cases (IR=71.7 PYR), followed by lumbar spine fractures (IR=14.7), and pelvic fractures (IR=14.3). The incidence of lower trunk fractures among super elderly females (IR=121.5 PYR) was significantly greater than that of males (IR=65.7 PYR). The incidence of lower trunk fractures among nonagenarians and centenarians was significantly higher than that of octogenarians. Accounting for population growth yielded a significantly increasing annual incidence of lower trunk fractures in super elderly patients over the study period from 86.7 PYR in 2011 to 107.2 PYR in 2020 (AAPC=2.7, p<0.001). The annual incidence of both pelvic (AAPC=5.8) and lumbar spine (AAPC=6.9) fractures increased at a significantly higher rate than that of hip fractures (AAPC=1.4).
This study suggests that the annual incidence of lower trunk fractures in the oldest cohort of patients in the US (80+ years of age) increased significantly during the recent decade from 2011 to 2020, with pelvic and lumbar fractures in particular becoming increasingly common. Increased incidence rates highlight the need for future research aimed at optimizing outcomes and quality of life in this frail and ever-growing segment of the population.
老年人中最常见的骨折之一是下躯干骨折。超高龄人群（即 80 岁及以上人群）是人口中不断增长的一部分，尤其容易发生此类骨折。目前文献中对超高龄人群下躯干骨折的当代流行病学情况描述并不完整。
本描述性流行病学研究使用国家电子伤害监测系统（NEISS），从 2011 年至 2020 年期间，在美国（US）检查超高龄人群（80 岁及以上）下躯干骨折（即髋部、骨盆和腰椎骨折）的发生率和近期趋势。分析了总体和年龄/性别特异性的发生率（IR）。计算了平均年百分比变化（AAPC）估计值，以表明年度伤害发生率的幅度/方向。
在 10 年的研究期间，估计有 1226160 名超高龄患者发生下躯干骨折，总的发病率为每 10000 人年风险（PYR）100.2 例。髋部骨折占病例的最大比例（IR=71.7 PYR），其次是腰椎骨折（IR=14.7）和骨盆骨折（IR=14.3）。超高龄女性（IR=121.5 PYR）下躯干骨折的发生率明显高于男性（IR=65.7 PYR）。非百岁老人和百岁老人的下躯干骨折发生率明显高于 80 岁老人。考虑到人口增长，超高龄患者下躯干骨折的年发生率在研究期间从 2011 年的 86.7 PYR 显著增加到 2020 年的 107.2 PYR（AAPC=2.7，p<0.001）。骨盆（AAPC=5.8）和腰椎（AAPC=6.9）骨折的年发生率增加速度明显快于髋部骨折（AAPC=1.4）。
本研究表明，美国最年长患者群体（80 岁以上）下躯干骨折的年发生率在最近十年（2011 年至 2020 年）显著增加，尤其是骨盆和腰椎骨折变得越来越常见。发病率的增加突出表明需要进行未来研究，旨在优化这一脆弱且不断增长人群的结局和生活质量。
