A survey of outcomes and management of patients post fragility fractures in China

被引:225
作者
Wang, O. [1 ]
Hu, Y. [2 ]
Gong, S. [3 ]
Xue, Q. [4 ]
Deng, Z. [5 ]
Wang, L. [6 ]
Liu, H. [7 ]
Tang, H. [8 ]
Guo, X. [9 ]
Chen, J. [10 ]
Jia, X. [11 ]
Xu, Y. [12 ]
Lan, L. [13 ]
Lei, C. [14 ]
Dong, H. [15 ]
Yuan, G. [16 ]
Fu, Q. [17 ]
Wei, Y. [18 ]
Xia, W. [1 ]
Xu, L. [19 ]
机构
[1] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Endocrinol, Key Lab Endocrinol,Minist Hlth, Beijing, Peoples R China
[2] Banan Peoples Hosp Chongqing, Chongqing, Peoples R China
[3] Shenyang Orthoped Hosp, Shenyang, Liaoning, Peoples R China
[4] Beijing Hosp, Beijing, Peoples R China
[5] Chongqing Med Univ, Hosp 2, Chongqing, Peoples R China
[6] 309th Hosp PLA, Beijing, Peoples R China
[7] Beijing Jishuitan Hosp, Beijing, Peoples R China
[8] Capital Med Univ, Beijing Friendship Hosp, Beijing, Peoples R China
[9] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Hubei, Peoples R China
[10] Peoples Hosp Zhejiang, Hangzhou, Zhejiang, Peoples R China
[11] Wuyi First Peoples Hosp, Wuyi, Zhejiang, Peoples R China
[12] Suzhou Univ, Hosp 2, Suzhou, Jiangsu, Peoples R China
[13] Wuzhong Peoples Hosp Suzhou, Wuzhong, Jiangsu, Peoples R China
[14] Ningxia Med Univ, Gen Hosp, Ningxia, Yinchuan, Peoples R China
[15] Capital Med Univ, Beijing Shijingshan Hosp, Shijingshan Teaching Hosp, Beijing, Peoples R China
[16] Xinzhou Dist Peoples Hosp Wuhan, Wuhan, Hubei, Peoples R China
[17] China Med Univ, Shengjing Hosp, Shenyang, Liaoning, Peoples R China
[18] Yanchi Hosp, Ningxia, Peoples R China
[19] Chinese Acad Med Sci, Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Obstet & Gynecol, Beijing 100730, Peoples R China
基金
北京市自然科学基金;
关键词
China; Diagnosis; Fragility fracture; Mortality; Self-care ability; Treatment; HIP FRACTURE; MULTIFACETED INTERVENTION; POSTMENOPAUSAL WOMEN; EXCESS MORTALITY; OSTEOPOROSIS TREATMENT; VERTEBRAL FRACTURES; WRIST FRACTURE; OLDER WOMEN; FOLLOW-UP; MEN;
D O I
10.1007/s00198-015-3162-6
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
We found that the fragility hip and vertebral fractures caused excess mortality rates in this Chinese female population, which was unexpectedly lower than those in western countries and other Asian countries. This was the first nationwide survey relating to post-fracture outcomes conducted among Chinese population in Mainland China. Introduction This study aimed to investigate the mortality, self-care ability, diagnosis, and medication treatment of osteoporosis following fragility hip and vertebral fractures through a nationwide survey among female patients aged over 50 in Mainland China. Methods This was a multicenter, retrospective cohort study based on medical chart review and patient questionnaire. Female patients aged 50 or older admitted for low-trauma hip or vertebral fractures and discharged from Jan 1, 2008 to Dec 31, 2012 were followed. Results Total of 1151 subjects of hip fracture and 842 subjects of vertebral fracture were included. The mean age was 73.4 +/- 10.0, and the median of duration from index fracture to interview was 2.6 years. The overall 1-year, 2-year, 3-year, 4-year, and 5-year cumulative mortality rates were 3.5, 7.0, 11.2, 13.1, and 16.9 %, respectively. The first year mortality rates in hip (3.8 %, 95% CI 3.3-4.4 %) and vertebral fracture (3.1 %, 95% CI 2.5-3.7 %) were significantly higher than that in the general population (1.6 %). Impaired self-care ability was observed in 33.2, 40.6, and 23.8 % of overall, hip fracture, and vertebral fracture group, respectively. The overall diagnosis rate of osteoporosis was 56.8 %, and bone mineral density (BMD) measurement had never been conducted in 42.0 % among these women. After the index fracture, 69.6 % of them received supplements and/or anti-osteoporotic medications, among which 39.6 % only received calcium with/without vitamin D supplementation. Conclusions The osteoporotic hip and vertebral fractures caused excess mortality rates in this population of Mainland China. The current diagnosis and medical treatment following the fragility fractures is still insufficient in Mainland China.
引用
收藏
页码:2631 / 2640
页数:10
相关论文
共 38 条
[1]
Excess mortality following hip fracture: a systematic epidemiological review [J].
Abrahamsen, B. ;
van Staa, T. ;
Ariely, R. ;
Olson, M. ;
Cooper, C. .
OSTEOPOROSIS INTERNATIONAL, 2009, 20 (10) :1633-1650
[2]
The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial [J].
Bessette, L. ;
Davison, K. S. ;
Jean, S. ;
Roy, S. ;
Ste-Marie, L. G. ;
Brown, J. P. .
OSTEOPOROSIS INTERNATIONAL, 2011, 22 (12) :2963-2972
[3]
Factors influencing the treatment of osteoporosis following fragility fracture [J].
Bessette, L. ;
Jean, S. ;
Davison, K. S. ;
Roy, S. ;
Ste-Marie, L. -G. ;
Brown, J. P. .
OSTEOPOROSIS INTERNATIONAL, 2009, 20 (11) :1911-1919
[4]
Mortality Risk Associated With Low-Trauma Osteoporotic Fracture and Subsequent Fracture in Men and Women [J].
Bliuc, Dana ;
Nguyen, D. Nguyen ;
Milch, Vivienne E. ;
Nguyen, Tuan V. ;
Eisman, John A. ;
Center, Jacqueline R. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2009, 301 (05) :513-521
[5]
Effect of Osteoporosis Treatment on Mortality: A Meta-Analysis [J].
Bolland, Mark J. ;
Grey, Andrew B. ;
Gamble, Greg D. ;
Reid, Ian R. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2010, 95 (03) :1174-1181
[6]
Mortality After Hip Fracture in Austria 2008-2011 [J].
Brozek, Wolfgang ;
Reichardt, Berthold ;
Kimberger, Oliver ;
Zwerina, Jochen ;
Dimai, Hans Peter ;
Kritsch, Daniela ;
Klaushofer, Klaus ;
Zwettler, Elisabeth .
CALCIFIED TISSUE INTERNATIONAL, 2014, 95 (03) :257-266
[7]
Risk of mortality following clinical fractures [J].
Cauley, JA ;
Thompson, DE ;
Ensrud, KC ;
Scott, JC ;
Black, D .
OSTEOPOROSIS INTERNATIONAL, 2000, 11 (07) :556-561
[8]
Public Health Impact of Osteoporosis [J].
Cauley, Jane A. .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2013, 68 (10) :1243-1251
[9]
Mortality after all major types of osteoporotic fracture in men and women: an observational study [J].
Center, JR ;
Nguyen, TV ;
Schneider, D ;
Sambrook, PN ;
Eisman, JA .
LANCET, 1999, 353 (9156) :878-882
[10]
Secular trends in the incidence of hip and other osteoporotic fractures [J].
Cooper, C. ;
Cole, Z. A. ;
Holroyd, C. R. ;
Earl, S. C. ;
Harvey, N. C. ;
Dennison, E. M. ;
Melton, L. J. ;
Cummings, S. R. ;
Kanis, J. A. .
OSTEOPOROSIS INTERNATIONAL, 2011, 22 (05) :1277-1288