老年髋部骨折术后对侧髋部再骨折危险因素的荟萃分析Risk factors of the second contralateral hip fracture after surgery for hip fracture in the elderly: a meta-analysis
吴晓天;潘福根;付文芹;翟启麟;
摘要(Abstract):
[目的]通过荟萃分析探讨影响老年髋部骨折术后对侧髋部再骨折的危险因素。[方法]检索Medline、Cochrane Database、Embase Database等外文医学数据库,收集2000年1月~2018年3月国外公开发表的有关老年髋部骨折术后对侧髋部再骨折危险因素的英文文献,严格评价纳入研究的质量并提取资料,应用Revman 5.3软件进行系统分析。[结果]共纳入20篇英文文献,对侧髋部再骨折患者2 542例,单侧髋部骨折对照患者27 949例。影响髋部再骨折的危险因素有患者性别(OR=1.55,95%CI 1.39~1.73,P<0.01)、心脏病(OR=1.34,95%CI 1.03~1.75,P=0.03)、老年痴呆(OR=1.67,95%CI 1.29~2.15,P<0.01)、呼吸系统疾病(OR=1.86,95%CI 1.06~3.27,P=0.03)、视觉障碍(OR=1.90,95%CI 1.27~2.84,P=0.002),而与年龄、BMI、ASA评分、初次髋部骨折类型、手术方案、Singh指数、BMD、抗骨质疏松药物治疗、糖尿病、高血压病、脑卒中、骨骼系统疾病、酗酒嗜好无关。[结论]女性、心脏病、老年痴呆、呼吸系统疾病、视觉障碍是老年髋部骨折术后对侧髋部再骨折的独立危险因素。
关键词(KeyWords): 老年;髋部骨折;再骨折;系统评价
基金项目(Foundation):
作者(Author): 吴晓天;潘福根;付文芹;翟启麟;
Email:
DOI:
参考文献(References):
- [1]Mazzucchelli R,Pérez-Fernández E,CrespíN,et al.Second hip fracture:incidence,trends,and predictors[J].Calcif Tissue Int,2018,(0216):619-626.
- [2]田守进,赵理平,倪善军,等.老年髋部骨折术后对侧髋部再骨折的影响因素分析[J].中华创伤骨科杂志,2015,17(2):124-128.
- [3]Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.
- [4]Angthong C,Suntharapa T,Harnroongroj T.Major risk factors for the second contralateral hip fracture in the elderly[J].Acta Orthop Traumatol Turc,2009,43(3):193-198.
- [5]Batin S,Ozan F,Gurbuz K,et al.Evaluation of risk factors for second hip fractures in elderly patients[J].J Clin Med Res,2018,10(3):217-220.
- [6]Chang JD,Yoo JH,Reddy P,et al.Risk factors for contra-lateral hip fracture in elderly patients with previous hip fracture[J].Injury,2013,44(12):1930-1933.
- [7]Dinah AF.Sequential hip fractures in elderly patients[J].Injury,2002,33(5):393-394.
- [8]Fukushima T,Sudo A,Uchida A.Bilateral hip fractures[J].J Orthop Sci,2006,11(5):435-438.
- [9]Gaumetou E,Zilber S,Hernigou P.Non-simultaneous bilateral hip fracture:Epidemiologic study of 241 hip fractures[J].Orthop Traumatol Surg Res,2011,97(1):22-27.
- [10]Hagino H,Sawaguchi T,Endo N,et al.The risk of a second hip fracture in patients after their first hip fracture[J].Calcif Tissue Int,2012,90(1):14-21.
- [11]Juhász K,Boncz I,Patczai B,et al.Risk factors for contralateral hip fractures following femoral neck fractures in elderly:analysis of the Hungarian nationwide health insurance database[J].Eklem Hastalik Cerrahisi,2016,27(3):146-152.153
- [12]Lau JC,Ho KW,Sadiq S.Patient characteristics and risk of subsequent contralateral hip fracture after surgical management of first fracture[J].Injury,2014,45(10):1620-1623.
- [13]Lawrence TM,Wenn R,Boulton CT,et al.Age-specific incidence of first and second fractures of the hip[J].J Bone Joint Surg Br,2010,92(2):258-261.
- [14]Lee SH,Lee TJ,Cho KJ,et al.Subsequent hip fracture in osteoporotic hip fracture patients[J].Yonsei Med J,2012,53(5):1 005-1009.
- [15]Lee YK,Ha YC,Yoon BH,et al.Incidence of second hip fracture and compliant use of bisphosphonate[J].Osteoporos Int,2013,24(7):2099-2104.
- [16]Lee KH,Kim JY,Yim SJ,et al.Incidence and Risk Factors of Subsequent Hip Fractures in Korea:Multicenter Study[J].J Korean Medical Science,2014,29(7):992-994.
- [17]L?nnroos E,Kautiainen H,Karppi P,et al.Incidence of second hip fractures.A population-based study[J].Osteoporos Int,2007,18(9):1279-1285.
- [18]Mitani S,Shimizu M,Abo M,et al.Risk factors for second hip fractures among elderly patients[J].J Orthop Sci,2010,15(2):192-197.
- [19]Rodaro E,Pasqualini M,Iona LG,et al.Functional recovery following a second hip fracture[J].Europa Medicophysica,40(3):179-183.
- [20]Sawalha S,Parker MJ.Characteristics and outcome in patients sustaining a second contralateral fracture of the hip[J].J Bone Joint Surg Br,2012,94(1):102-106.
- [21]Souder CD,Brennan ML,Brennan KL,et al.The rate of contralateral proximal femoral fracture following closed reduction and percutaneous pinning compared with arthroplasty for the treatment of femoral neck fractures[J].J Bone Joint Surg,2012,94(5):418-425.
- [22]Vochteloo AJ,Borger van der Burg BL,R?ling MA,et al.Contralateral hip fractures and other osteoporosis-related fractures in hip fracture patients:incidence and risk factors.An observational cohort study of 1,229 patients[J].Arch Orthop Trauma Surg,2012,132(8):1191-1197.
- [23]Yamanashi A,Yamazaki K,Kanamori M,et al.Assessment of risk factors for second hip fractures in Japanese elderly[J].Osteoporos Int,2005,16(10):1239-1246.
- [24]Liu S,Zhu Y,Chen W,et al.Risk factors for the second contralateral hip fracture in elderly patients:a systematic review and metaanalysis[J].Clin Rehabil,2015,29(3):285-294.
- [25]Gnudi S,Sitta E,Fiumi N.Bone density and geometry in assessing hip fracture risk in post-menopausal women[J].Br J Radiol,2007,80(959):893-897.
- [26]刘文和,刘忠厚,陈鹏.老年人骨质疏松性髋部骨折与Singh指数和股骨近端几何结构的相关性初探[J].中国骨质疏松杂志,2012,18(3):193-196.
- [27]刘路辉,刘智.老年髋部骨折类型与股骨近端骨密度的关系[J].中国骨质疏松杂志,2017,23(4):477-482.154
- [28]Sale JE,Bogoch E,Meadows L,et al.Bone mineral density reporting underestimates fracture risk in ontario[J].Health,2015,7(5):566-571.
- [29]Sennerby U,Melhus H,Gedeborg R,et al.Cardiovascular diseases and risk of hip fracture[J].JAMA,2009,302(15):1666-1673.
- [30]王晓伟,刘智,张建政,等.老年髋部骨折术后发生谵妄危险因素分析[J].中华创伤杂志,2017,33(6):505-509.2018-08-16