Nahit E S, Silman A J, Macfarlane G J
Epidemiology Research Unit, School of Epidemiology and Health Sciences, University of Manchester.
Ann Rheum Dis. 1998 Mar;57(3):166-8. doi: 10.1136/ard.57.3.166.
To establish the risk of falling among those who consult their general practitioner with a new episode of hip pain and to discover if risk is altered by age and according to whether, at presentation, signs of osteoarthritis are present on radiography.
A case-control study was conducted. Cases were all patients who presented with a new episode of hip pain to participating general practices throughout the United Kingdom. All cases had a pelvic radiograph taken on recruitment to the study. Three controls were matched for sex, age, and general practice to each case. A questionnaire was sent by post to all cases and controls. The risk of having fallen in the past 12 months among cases and controls was compared.
The study included 111 cases presenting with hip pain and 229 controls who had not consulted with hip pain in the previous 12 months. Women (odds ratio = 3.6, 95% CI 1.9, 6.7) but not men (odds ratio = 0.8, 95% CI 0.3, 2.3) reported an increased risk of falling in the previous 12 months. Similar results were obtained when the previous four months were considered. For all cases, hip pain predated any reported falls. The increased risk in women was found particularly for those aged less than 70. Risk of falling was not altered by the presence of radiological changes of osteoarthritis.
Hip pain, which may be a symptom of osteoarthritis of the hip, increases the risk of falling. This finding has implications for the advice offered by general practitioners to patients who consult with early hip pain.
确定因新发髋部疼痛而咨询全科医生的人群中跌倒的风险，并探究风险是否因年龄以及就诊时X线片上是否存在骨关节炎迹象而有所改变。
开展一项病例对照研究。病例为全英国参与研究的全科诊所中所有出现新发髋部疼痛的患者。所有病例在纳入研究时均拍摄了骨盆X线片。为每个病例匹配三名性别、年龄和全科诊所相同的对照。通过邮寄方式向所有病例和对照发送问卷。比较病例组和对照组在过去12个月内跌倒的风险。
该研究纳入了111例髋部疼痛患者和229名在过去12个月内未因髋部疼痛就诊的对照。女性（比值比 = 3.6，95%可信区间1.9，6.7）而非男性（比值比 = 0.8，95%可信区间0.3，2.3）报告在过去12个月内跌倒风险增加。考虑过去四个月时也得到了类似结果。对于所有病例，髋部疼痛先于任何报告的跌倒出现。女性中跌倒风险增加尤其见于年龄小于70岁者。骨关节炎的放射学改变并未改变跌倒风险。
髋部疼痛可能是髋部骨关节炎的症状，会增加跌倒风险。这一发现对全科医生向因早期髋部疼痛就诊的患者提供的建议具有启示意义。
