Koehne Niklas H, Locke Auston R, Jain Charu, Namiri Nikan K, Yendluri Avanish, Podolnick Jeremy, Ryan Scott, Forsh David A, Cannada Lisa K, Parisien Robert L
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Injury. 2025 Aug;56(8):112550. doi: 10.1016/j.injury.2025.112550. Epub 2025 Jun 23.
Introduction Geriatric fractures are a major contributor of morbidity and mortality in elderly patients and represent a large resource burden on healthcare institutions across the United States. Elderly populations are predicted to increase in the coming decades, motivating epidemiological studies that may inform more effective and targeted prevention measures for these injuries. Methods Data analyzed in this study was extracted from the National Electronic Injury Surveillance System (NEISS), a public database representing approximately 100 US EDs to provide national injury estimates. NEISS was queried for all fracture ED admissions among patients age 65 and older. Fracture events were restricted to injuries from January 1, 2019 to December 31, 2023. Results A geriatric fracture NEISS query resulted in 82,953 ED visits, extrapolating to a total national estimate of 3852,261 fractures presenting to US EDs across the study period. The overall hospitalization rate was 54.8 %, increasing to 74.5 % by age 99. Linear regression of fractures rates by year demonstrated a significant increase in male fractures over time (p = 0.047, β = 7688). Compared to females, males were also more likely to sustain trunk fractures and become injured at sporting facilities. Older patients also saw higher rates of trunk fractures (including upper and lower trunk), while rates of extremity fractures (upper and lower extremities) decreased with age. Fractures in the home also decreased with age, while those occurring on public property (including assisted living facilities) increased with age. Conclusion Increasing fracture rates among males indicates an opportunity for improved prevention measures among men 65 and older. Males were also more likely to sustain fractures while participating in sports, and may therefore benefit from education programs on fracture risk. Geriatric fractures were more likely to occur on public property such as sidewalks and assisted living facilities as patients aged, demonstrating the need for improved precautionary measures such as low-floor beds, hip protectors, fall alarms, and wearable devices.
引言
老年骨折是老年患者发病和死亡的主要原因，给美国各地的医疗机构带来了巨大的资源负担。预计在未来几十年里老年人口将会增加，这促使开展流行病学研究，以便为这些损伤制定更有效、更具针对性的预防措施提供依据。
方法
本研究分析的数据取自国家电子伤害监测系统（NEISS），这是一个代表约100家美国急诊科的公共数据库，用于提供全国伤害估计数。在NEISS中查询了65岁及以上患者的所有骨折急诊入院情况。骨折事件仅限于2019年1月1日至2023年12月31日期间的损伤。
结果
对老年骨折的NEISS查询产生了82,953次急诊就诊记录，据此推断在整个研究期间美国急诊科共接收了3,852,261例骨折患者。总体住院率为54.8%，到99岁时升至74.5%。按年份对骨折发生率进行线性回归分析显示，男性骨折发生率随时间显著增加（p = 0.047，β = 7688）。与女性相比，男性也更有可能发生躯干骨折以及在体育设施中受伤。老年患者的躯干骨折（包括上躯干和下躯干）发生率也更高，而四肢骨折（上肢和下肢）发生率则随年龄增长而下降。在家中发生的骨折也随年龄增长而减少，而在公共财产（包括辅助生活设施）上发生的骨折则随年龄增长而增加。
结论
男性骨折发生率上升表明有机会改进65岁及以上男性的预防措施。男性在参加体育活动时也更有可能发生骨折，因此可能会从骨折风险教育项目中受益。随着患者年龄增长，老年骨折更有可能发生在人行道和辅助生活设施等公共财产上，这表明需要改进预防措施，如使用低地板床、髋部保护器、跌倒报警器和可穿戴设备。
