Diamond T H, Thornley S W, Sekel R, Smerdely P
St George Hospital, Sydney, NSW.
Med J Aust. 1997 Oct 20;167(8):412-5. doi: 10.5694/j.1326-5377.1997.tb126646.x.
To examine prognostic factors and outcomes after hip fracture in men aged 60 years and older.
Cohort study of all men presenting to St George Hospital (a 650-bed tertiary care centre) with hip fractures in 1995, recruited retrospectively from medical records and evaluated prospectively at six and 12 months after fracture.
51 men aged 60 years or more (and, for comparison, 51 age-matched women) who presented with hip fracture not caused by high impact injuries or local bone disease.
Prognostic factors (such as pre-existing illness and osteoporotic risk factors) and outcome data (such as fracture-related complications, mortality, and level of function as measured by the Barthel index of activities of daily living at six and 12 months postfracture).
Median age of the 51 men was 80 years (interquartile range, 74-86 years); four were aged under 70 years. Outcome assessment was possible for 41 men (80%). Similar proportions of men and women came from institutions (32% v. 28%), and similar additional proportions required institutionalisation after discharge (18% v. 14%). Fracture-related complications affected similar proportions of men and women (30% v. 32%), and mean length of hospital stay was similar. Fourteen per cent of men died in hospital compared with only 6% of women (P = 0.06). Men had more risk factors for osteoporosis (P < 0.01). Physical functioning (measured by the Barthel index) deteriorated significantly in men from 14.9 at baseline to 13.4 at six months (P < 0.05) and 12.4 at 12 months (P < 0.05) after fracture.
Compared with women, elderly men presenting with hip fracture have higher mortality and have more risk factors for osteoporosis. Like women with hip fracture, men are usually fragile, with pre-existing medical illness and fracture-related complications contributing to their overall poor outcomes.
研究60岁及以上男性髋部骨折后的预后因素及结局。
对1995年在圣乔治医院（一家拥有650张床位的三级护理中心）因髋部骨折就诊的所有男性进行队列研究，通过病历进行回顾性招募，并在骨折后6个月和12个月进行前瞻性评估。
51名60岁及以上的男性（作为对照，还有51名年龄匹配的女性），他们因髋部骨折就诊，骨折并非由高冲击力损伤或局部骨病所致。
预后因素（如既往疾病和骨质疏松风险因素）以及结局数据（如骨折相关并发症、死亡率，以及骨折后6个月和12个月通过日常生活活动能力巴氏指数测量的功能水平）。
51名男性的中位年龄为80岁（四分位间距为74 - 86岁）；4名年龄在70岁以下。41名男性（80%）可进行结局评估。来自机构的男性和女性比例相似（32%对28%），出院后需要入住机构的额外比例也相似（18%对14%）。骨折相关并发症在男性和女性中的发生率相似（30%对32%），平均住院时间也相似。14%的男性在医院死亡，而女性仅为6%（P = 0.06）。男性骨质疏松的风险因素更多（P < 0.01）。骨折后，男性的身体功能（通过巴氏指数测量）从基线时的14.9显著下降至6个月时的13.4（P < 0.05）和12个月时的12.4（P < 0.05）。
与女性相比，老年男性髋部骨折后的死亡率更高，骨质疏松的风险因素更多。与髋部骨折的女性一样，男性通常较为脆弱，既往疾病和骨折相关并发症导致其总体预后较差。
