Bacon Catherine J, Moyes Simon A, Hikaka Joanna, Teh Ruth, Atlasz Astrid E A, Kerse Ngaire
School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, PO Box 92019, Auckland, 1142, New Zealand.
Orthosports North Harbour Ltd, Auckland, New Zealand.
Arch Osteoporos. 2025 Apr 9;20(1):48. doi: 10.1007/s11657-025-01528-1.
Longitudinal data quantifying fracture rates beyond 80 years are lacking. Over 5 years, hospitalised fracture incidences increased by 85% in Māori and 73% in non-Māori octogenarians. However, while fracture-related hospital nights increased by 107% in non-Māori, they remained stable for Māori. Hospitalised fracture risk increases markedly with 5 years of advanced ageing.
Fractures become increasingly common in people beyond 80 years, the most serious resulting in hospitalisation. This study examines longitudinal changes in hospitalised fractures in octogenarians.
Hospital discharge records from a cohort study of Māori aged 80-90 years and non-Māori turning 85 years (LiLACS NZ) were used to determine the incidence of hospitalised fractures for 5 years before and 5 years after enrolment.
Records were available for 378 Māori (aged 82.6 ± 2.8 years; mean ± SD) and 498 non-Māori (84.6 ± 0.5 years). In the 5 years prior to enrolment, 22 (5.8%) Māori and 43 (8.6%) non-Māori were hospitalised at least once for fracture, and 29 (7.7%) Māori and 62 (12.4%) non-Māori sustained hospitalised fractures in the 5 years following enrolment. Hospitalised fracture incidences were 1270/100,000 person-years in Māori and 2048/100,000 person-years in non-Māori before enrolment, increasing to 2345 (P = 0.02) and 3541 (P = 0.002) /100,000 person-years in the subsequent 5 years, respectively. Pelvis/femoral fractures accounted for almost half (47%) of fractures. Fracture-related hospital nights increased 107% in non-Māori (P < 0.0001), but remained stable for Māori, from before to after enrolment. Following enrolment, 21% of hospital nights spent by non-Māori women were fracture-related.
In octogenarians, hospitalised fracture risk increased markedly with 5 years of ageing, almost doubling fracture-related hospitalisation time in non-Māori but having little effect on time spent in hospital for Māori. Projections of fracture burden in advanced age need to consider rapidly changing risk with small increases in age and differences between demographic groups.
缺乏量化80岁以上骨折发生率的纵向数据。在5年时间里，毛利族八旬老人的住院骨折发生率增加了85%，非毛利族八旬老人增加了73%。然而，虽然非毛利族与骨折相关的住院天数增加了107%，但毛利族的这一数据保持稳定。随着5年的高龄增长，住院骨折风险显著增加。
骨折在80岁以上人群中越来越常见，最严重的情况会导致住院。本研究调查八旬老人住院骨折的纵向变化。
利用对80 - 90岁毛利族和85岁非毛利族进行队列研究的医院出院记录，确定入组前5年和入组后5年的住院骨折发生率。
有378名毛利人（年龄82.6±2.8岁；均值±标准差）和498名非毛利人（84.6±0.5岁）的记录可用。在入组前的5年里，22名（5.8%）毛利人和43名（8.6%）非毛利人至少因骨折住院一次，在入组后的5年里，29名（7.7%）毛利人和62名（12.4%）非毛利人发生了住院骨折。入组前，毛利族的住院骨折发生率为每10万人年1270例，非毛利族为每10万人年2048例，在随后的5年里分别增至每10万人年2345例（P = 0.02）和3541例（P = 0.002）。骨盆/股骨骨折占骨折总数的近一半（47%）。非毛利族与骨折相关的住院天数从入组前到入组后增加了107%（P < 0.0001），但毛利族保持稳定。入组后，非毛利族女性的住院天数中有21%与骨折相关。
在八旬老人中，随着5年的年龄增长，住院骨折风险显著增加，非毛利族与骨折相关的住院时间几乎翻倍，但对毛利族的住院时间影响不大。高龄骨折负担的预测需要考虑年龄小幅增加时风险的快速变化以及不同人群之间的差异。
