摘要
目的通过文献分析探析中国老年髋部骨折流行病学特征及研究现状,以期为防治老年髋部骨折提供一定的依据。方法计算机检索PubMed、Web of science、Cochrane、中国生物医学文献数据库(Chinese biomedical literature,CBM)、Embase、中国知网、维普、万方数据库中公开发表的有关我国老年髋部骨折流行病学特征病例系列研究的文献,由2名研究人员独立检索、筛选文献,并对纳入的文献依据病例系列研究质量评价(institute health economics,IHE)工具进行偏倚风险评价,使用GraphPad Prism 8软件进行数据提取,SPSS 21.0统计学软件进行数据分析。结果共检索到245篇文献,其中17篇符合纳入标准,共75407例患者,其中男性24552例(32.6%),女性50855例(67.4%)。7项研究以年龄为组别将患者分为4组合计10014例:60~69岁组共2296例(22.9%),其中男性925例,女性1371例;70~79岁组共3855例(38.5%),其中男性1367例,女性2488例;80~89岁组共3187例(31.8%),其中男性1098例,女性2089例;90岁及以上组676例(6.8%),其中男性209例,女性467例。各年龄组女性患者均多于男性患者,差异具有统计学意义(χ^(2)=29.70,P<0.001)。11项研究提及骨折类型,共纳入13791例患者,股骨转子间骨折6941例(49.7%),股骨颈骨折6850(50.3%),其中有6项研究以年龄为组别将患者分为4组合计8172例:60~69岁组共2048例,其中股骨颈骨折1286例,股骨转子间骨折762例;70~79岁组共2787例,其中股骨颈骨折1367例,股骨转子间骨折1306例;80~89岁组共2779例,其中股骨颈骨折1255例,股骨转子间骨折1524例;90岁及以上组588例,其中股骨颈骨折210例,股骨转子间骨折348例。各年龄组骨折类型构成比差异无统计学意义(χ^(2)=195.0,P>0.05)。8项研究提及发病因素,共纳入5657例患者,其中跌倒引起共5047例(89.2%)。3项研究提及发病与季节的关系,共3422例,春季845例(24.7%)、夏季784例(22.9%)、秋季795例(23.2%)、冬季998例(29.2%),冬季高于其他季节,且差异具有统计学意义(χ^(2)=17.35,P<0.001)。结论此次文献归纳综合分析显示,近十年我国老年髋部骨折患者女性多于男性,男女比例约为1︰2;70~79岁年龄组患者比例高于其他组,90岁及以上年龄组比例低于其他组;股骨转子间骨折与股骨颈骨折患者数量约为1︰1;跌倒为发病因素占比89.2%;冬季患者发病数量高于其他季节;住院时间长,住院治疗费用高。
Objective To explore the epidemiological characteristics and research status of elderly hip fractures in Chinaand provide some basis for the prevention and treatment of elderly hip fracturebyliterature analysis.Methods The literaturerelated to epidemiologyof elderly hip fractures published in PubMed,Web of Science,Cochrane,Chinese Biomedical Literature(CBM),Embase,CNKI,VIP,and Wanfang Database weresearched.The literaturewere searched and screened by two researchers independently.Quality assessment of case-series studieswereusedto assess the risk of bias for the selected literature.And data was extracted using GraphPad Prism 8 software and analyzed using SPSS 21.0 statistical software.Results A total of 245 literature were searched,17 of which met the inclusion criteria.A total of 75407 patients were included.There were 24552 males(32.6%)and 50855 females(67.4%).10014 patients were divided into 4 groups by ages in 7 studies.There were a total of 2296 cases(22.9%)in the group aged 60 to 69,including 925 males and 1371 females.There were 3855 cases(38.5%)in the group aged 70 to 79,including 1367 males and 2488 females.There were 3187 cases(31.8%)in the group aged 80 to 89,including 1098 males and 2089 females.There were 676 cases(6.8%)in the group aged 90 and older,including 209 males and 467 females.There were more female patients than male patients in all age groups,and the differencewere statistically significant(χ^(2)=29.70,P<0.001).Fracture types were mentioned in 11 studies,including 13791 patients,6941 cases(49.7%)of intertrochanteric fractures and 6850 cases(50.3%)of femoral neck fractures,of which 6 studies divide 8172 patients into 4 groups by ages:There were 2048 cases in the group aged 60 to 69,including 1286 cases of femoral neck fracture and 762 cases of intertrochanteric fracture.There were 2787 cases in the group aged 70 to 79,including 1367 cases of femoral neck fracture and 1306 cases of intertrochanteric fracture.There were 2779 cases in the group aged 80 to 89,including 1255 cases of femoral neck fracture and 1524 cases of intertrochanteric fracture.There were 588 cases in the group aged 90 and older,there were 210 cases of femoral neck fracture and 348 cases of intertrochanteric fracture.There wa no significant difference in terms of fracture type constituent ratio among different age groups(χ^(2)=195.0,P>0.05).A total of 5657 patients were included,of which there were 5047 cases(89.2%)caused by falls.The relationship between the incidence and season is mentioned in 3 studies,reaching 3422 cases,845 cases(24.7%)in spring,784 cases(22.9%)in summer,795 cases(23.2%)in autumn,and 998 cases(29.2%)in winter.Compared with other seasons,there were more cases in winter,and the difference was statistically significant(χ^(2)=17.35,P<0.001).Conclusion The comprehensive analysis of the literature shows that the number of elderly hip fracture patients in China is more than that of men in the past ten years,and the male to female ratio is about 1:2.The proportion of patients aged 70 to 79 is higher than that of other groups,and the proportion of patients aged 90 and above is lower than that of other groups.The ration of patients with intertrochanteric fracture and femoral neck fracture is about 1︰1.Among epidemic factors,falls account for 89.2%;The number of patients in winter is higher than that in other seasons.There is long hospital stay and high hospitalization costs.
作者
李兴国
邓叶龙
刘朝晖
杨德龙
王玉泉
孔令俊
Li Xingguo;Deng Yelong;Liu Zhaohui(Gansu Provincial Hospital of Traditional Chinese Medicine Lanzhou,Lanzhou 730050,China;Gansu University of Traditional Chinese Medicine Lanzhou,Lanzhou 730000,China)
出处
《实用骨科杂志》
2021年第7期601-606,共6页
Journal of Practical Orthopaedics
基金
甘肃省中医药管理局项目(GZKP-2020-19)。
关键词
老年髋部骨折
流行病学
临床特征
hip fractures of the elderly
epidemiology
clinical characteristics
