Nakamura T
Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1993 Apr;67(4):189-200.
These days, hip fractures are becoming serious health problem in elderly people. We have, therefore, conducted an epidemiological study in Tottori prefecture, Japan on the following elements related to the hip fracture of patients: the incidence, cause, environment, state of individual health, outcome and risk factors. We obtained data from hospital records and from hip fracture patients by mailed questionnaires. The incidence of hip fractures per 100000 person-years was 67.8 and 165.9 for male and female 50 years of age and older. This incidence is a half or one-third of that in North Europe or North America. We assume that the difference of physique and life style between Japanese and Caucasian have some effect on incidence. Almost all fractures occurred by falling over from a standing position. The incidence of distal radius fracture in past history is four times more frequent in female patients compared to that in males. About 12% of male and 19% of female patients aged 60 and over with hip fracture were demented before the injury. The case-control study revealed that thin figure and bed-ridden were significant risk factors for the hip fracture. Thin figure was more prevalent in the group with cervical fracture than that with the trochanteric fracture. Analyzing our data with the Cox proportional hazards model, our study has shown that male, aging and dementia were important factors in determining the life expectancy of patients with hip fracture.
如今,髋部骨折正成为老年人严重的健康问题。因此,我们在日本鸟取县开展了一项关于髋部骨折患者的流行病学研究,涉及以下与患者髋部骨折相关的因素:发病率、病因、环境、个人健康状况、预后及危险因素。我们通过医院记录和向髋部骨折患者邮寄问卷获取数据。50岁及以上男性和女性每10万人年的髋部骨折发病率分别为67.8和165.9。这一发病率是北欧或北美的一半或三分之一。我们认为日本人和白种人体质和生活方式的差异对发病率有一定影响。几乎所有骨折都是因从站立姿势摔倒所致。既往有桡骨远端骨折史的女性患者发病率是男性患者的四倍。60岁及以上髋部骨折男性患者和女性患者中,分别约有12%和19%在受伤前患有痴呆症。病例对照研究表明,身材消瘦和卧床不起是髋部骨折的重要危险因素。身材消瘦在颈椎骨折组比转子间骨折组更为普遍。通过Cox比例风险模型分析我们的数据,我们的研究表明,男性、年龄增长和痴呆症是决定髋部骨折患者预期寿命的重要因素。