Magaziner J, Lydick E, Hawkes W, Fox K M, Zimmerman S I, Epstein R S, Hebel J R
Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore 21201, USA.
Am J Public Health. 1997 Oct;87(10):1630-6. doi: 10.2105/ajph.87.10.1630.
The purpose of this study was to estimate the excess mortality attributable to hip fracture.
The 6-year survival rate of community-dwelling White female hip fracture patients aged 70 years and older entering one of seven hospitals from 1984 to 1986 (n = 578) was compared with that of White female respondents aged 70 years and older interviewed in 1984 for the Longitudinal Study on Aging (n = 3773).
After age, education, comorbidity, and functional impairment were controlled, the mortality differential between the two groups accumulated to an excess among hip fracture patients of 9 deaths per 100 women 5 years postfracture. Among those with three or more functional impairments or one or more comorbidities, the excess was 7 deaths per 100: the effect of the fracture had disappeared in these groups by 4 years. In contrast, those with two or fewer impairments and those with no comorbidities had a continuing trend of increased mortality, with an excess of 14 deaths per 100 by 5 years.
There is an immediate increase in mortality following a hip fracture in medically ill and functionally impaired patients, whereas among those with no comorbidities and few impairments, there is a gradual increase in mortality that continues for 5 years postfracture.
本研究旨在评估髋部骨折所致的额外死亡率。
将1984年至1986年期间进入七家医院之一的70岁及以上社区居住白人女性髋部骨折患者(n = 578)的6年生存率与1984年为老龄化纵向研究接受访谈的70岁及以上白人女性受访者(n = 3773)的6年生存率进行比较。
在对年龄、教育程度、合并症和功能障碍进行控制后,两组之间的死亡率差异在骨折后5年时累积为每100名女性中有9例髋部骨折患者死亡。在有三种或更多功能障碍或一种或更多合并症的患者中,额外死亡率为每100人中有7例:在这些组中,骨折的影响在4年后消失。相比之下,有两种或更少功能障碍且无合并症的患者死亡率持续上升趋势,到5年时每100人中有14例死亡。
患有内科疾病和功能障碍的患者髋部骨折后死亡率立即增加,而在无合并症且功能障碍较少的患者中,死亡率在骨折后5年内持续逐渐增加。