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首页> 外文期刊>Annals of epidemiology >Risk-adjusted mortality rates of elderly veterans with hip fractures.
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Risk-adjusted mortality rates of elderly veterans with hip fractures.

机译：老年髋部骨折退伍军人的风险调整后死亡率。

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PURPOSE: The goal of this research was to estimate 12-month survival rates for a large sample of elderly veterans after hip fracture with a risk-adjusted model and to compare the results of men to those of women. METHODS: The study design was a retrospective, secondary data analysis of national Veterans Health Administration (VHA) Medicare beneficiaries. The study population was 43,165 veterans with hip fracture first admitted to a Medicare-eligible facility during our specified enrollment period of 1999-2002. Measurement was a Cox proportional hazard model or survival analysis of hip fracture patients with an outcome of death over a 1 year period after discharge controlled by age, gender, and selected Elixhauser comorbidities. RESULTS: The unadjusted, 1 year mortality rates (30 days = 9.7%, 90 days = 17.5%, 180 days = 24%, 365 days = 32.2%) were slightly higher than the adjusted rates (30 days = 8.9%, 90 days = 15.6%, 180 days = 21.8%, 1 year = 29.9%). The mortality odds for women 12 months after hip fracture were 18%, compared with 32% for men. The comorbidity adjustment suggested that the presence of metastatic cancer increased the risk of death by almost 4 times compared with those patients without this diagnosis. Other particularly high-risk conditions included congestive heart failure, renal failure, liver disease, lymphoma, and weight loss, each of which increased the 1 year mortality risk by approximately two-fold. CONCLUSIONS: One in 3 elderly male veterans who sustain a hip fracture dies within 1 year. Our work represents the first large study of hip fractures with a predominantly male sample and confirms that men have a higher mortality risk than women, as reported by previous researchers who used smaller samples that were mostly female. Fracture patients with metastatic cancer, renal failure, lymphoma, weight loss, and liver disease have higher mortality risks. The adverse outcomes associated with hip fracture argue for clinical intervention strategies, such as gait and balance testing, and osteoporosis diagnosis that may prevent fractures in both genders.
机译：目的：本研究的目的是使用风险调整模型来评估髋关节骨折后大量老年退伍军人的12个月生存率，并将男性和女性的结果进行比较。方法：本研究设计是美国退伍军人健康管理局（VHA）医疗保险受益人的回顾性，辅助数据分析。研究人群为43165名髋骨骨折退伍军人，在我们指定的1999-2002年入学期间首次进入符合Medicare资格的设施。测量是髋关节骨折患者的Cox比例风险模型或生存分析，其出院后1年内死亡由年龄，性别和某些Elixhauser合并症控制。结果：未经调整的1年死亡率（30天= 9.7％，90天= 17.5％，180天= 24％，365天= 32.2％）略高于调整后的死亡率（30天= 8.9％，90天） = 15.6％，180天= 21.8％，1年= 29.9％）。女性髋部骨折后12个月的死亡率为18％，而男性为32％。合并症调整表明，转移性癌症的存在与未诊断的患者相比，死亡风险增加了近四倍。其他特别高风险的疾病包括充血性心力衰竭，肾衰竭，肝病，淋巴瘤和体重减轻，每一种都使一年死亡的风险增加了大约两倍。结论：髋关节骨折的三分之一老年男性退伍军人在一年内死亡。我们的工作代表了首次以男性样本为主要内容的大型髋部骨折研究，并证实男性比女性有更高的死亡风险，这是以前的研究人员曾报道的，他们使用的样本较小，多数为女性。具有转移性癌症，肾衰竭，淋巴瘤，体重减轻和肝病的骨折患者具有更高的死亡风险。与髋部骨折相关的不良结局需要临床干预策略，例如步态和平衡测试以及可以预防男女骨折的骨质疏松症诊断。

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