Xu L, Lu A, Zhao X, Chen X, Cummings S R
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, People's Republic of China.
Am J Epidemiol. 1996 Nov 1;144(9):901-7. doi: 10.1093/oxfordjournals.aje.a009024.
One third of the world's hip fractures are said to occur in Asia, mostly in China. However, there have as yet been no validated studies of hip fracture rates in China. The authors estimated the incidence of hip fractures in Beijing, People's Republic of China, and took several steps to validate the estimates. All 76 Beijing hospitals reported all 1988-1992 admissions that had been coded as 820 (hip fracture) or 821 (other femoral fracture) according to the International Classification of Diseases, Ninth Revision. The authors then compared a random sample of the reports with original medical records, and discovered that 70% of intertrochanteric hip fractures had been miscoded as "other femoral fractures." The authors retrained all hospital staffs to provide corrected reports. Revised reports missed only 13% of the hip fracture cases recorded in operating room logs of 11 randomly selected hospitals. To validate hospital-based estimates of hip fracture rates, the authors interviewed a random sample of 2,113 Beijing women aged 50 years or more (97% response rate); all but 4% of past fractures and all seven hip fractures had been treated in hospitals. Finally, the authors surveyed the 27 hospitals in the counties surrounding Beijing. No Beijing residents had been treated for hip fracture outside of the city. Based on the 1990 China census, age-standardized rates of hip fracture (per 100,000) in Beijing-87 for women, 97 for men-were much lower than those seen in Hong Kong in 1985 (353 for women, 181 for men) or in US Caucasians (510-559 for women, 174-207 for men). From 1988 to 1992, the rates in Beijing increased 34% in women and 33% in men. The authors conclude that hip fracture rates in Beijing are among the lowest in the world but may be rising rapidly.
据说全球三分之一的髋部骨折发生在亚洲，其中大部分在中国。然而，中国尚未有关于髋部骨折发生率的有效研究。作者估计了中华人民共和国北京市髋部骨折的发生率，并采取了多项措施来验证这些估计值。北京所有76家医院报告了1988年至1992年期间所有按照《国际疾病分类》第九版编码为820（髋部骨折）或821（其他股骨骨折）的住院病例。作者随后将报告的随机样本与原始病历进行比较，发现70%的转子间髋部骨折被错误编码为“其他股骨骨折”。作者对所有医院工作人员进行了重新培训，以提供更正后的报告。修订后的报告仅遗漏了11家随机选择医院手术室日志中记录的髋部骨折病例中的13%。为了验证基于医院的髋部骨折发生率估计值，作者对2113名年龄在50岁及以上的北京女性进行了随机抽样访谈（应答率为97%）；除4%的既往骨折外，所有七例髋部骨折均在医院接受治疗。最后，作者对北京周边各县的27家医院进行了调查。没有北京居民在城外接受过髋部骨折治疗。根据1990年中国人口普查，北京髋部骨折的年龄标准化发生率（每10万人）女性为87，男性为97，远低于1985年香港的发生率（女性为353，男性为181）或美国白种人的发生率（女性为510 - 559，男性为174 - 207）。1988年至1992年期间，北京女性的发生率上升了34%，男性上升了33%。作者得出结论，北京的髋部骨折发生率在世界上处于最低水平，但可能正在迅速上升。
