老年髋部骨折患者术后抗骨质疏松药物治疗现状及关联因素分析:一项全国多中心现况调查研究OACSTPCD
Status of and factors associated with anti-osteoporosis drug use among elderly patients with hip fracture:A nationwide cross-sectional study
背景 抗骨质疏松药物治疗是预防老年髋部骨折患者再骨折发生的重要手段,术后抗骨质疏松药物治疗的现状和关联因素尚不清楚.目的 明确我国老年髋部骨折患者术后抗骨质疏松药物治疗的现状和关联因素.方法 通过多阶段整群抽样法,调查全国31个省(自治区/直辖市)的594所医院骨质疏松性骨折患者,从中选取60岁以上髋部骨折手术患者作为调查对象.调查内容包括患者基本信息和骨折管理信息.采用多因素Logistic回归分析抗骨质疏松药物治疗的关联因素.结果 共计4 369例老年髋部骨折患者纳入研究,其中女性3 000例,男性1 369例.患者平均年龄(76.48±8.78)岁.患者的抗骨质疏松药物治疗率为21.8％.抗骨质疏松药物治疗的关联因素包括地区(华南vs华东,OR=0.64,95％CI:0.45～0.91;华中 vs 华东,OR=0.50,95％CI:0.37～0.68)、医院类别(综合医院 vs 专科医院,OR=1.77,95％CI:1.22～2.57)、家庭年收入[(10～20)万元 vs＜10 万元,OR=1.48,95％CI:1.21～1.82;(20～30)万元 vs＜10 万元,OR=2.11,95％CI:1.51～2.94;＞30 万元 vs＜10 万元,OR=2.14,95％CI:1.48～3.09]、合并肺炎(OR=1.99,95％CI:1.43～2.78)、合并脑卒中(OR=0.65,95％CI:0.45～0.93)、合并眼部疾病(OR=1.84,95％CI:1.10～3.06)、骨折风险评估史(OR=1.40,95％CI:1.02～1.93)、骨质疏松症知识知晓水平高(OR=1.26,95％CI:1.06～1.50)、骨折后使用钙片/维生素D(OR=5.32,95％CI:4.18～6.76)和院内骨密度检测(OR=2.94,95％CI:2.46～3.51).结论 我国老年髋部骨折患者术后抗骨质疏松药物治疗率较低.地区、医院类别、家庭年收入、合并症、骨折风险评估史、骨质疏松症知识知晓水平、骨折后使用钙片/维生素D和院内骨密度检测和是老年髋部骨折患者抗骨质疏松药物治疗的关联因素.
Background Anti-osteoporosis drug use is an effective way to prevent subsequent fractures among hip fracture patients.The associated risk factors of anti-osteoporosis drug use in elderly hip fractures patients are well investigated.Objective To investigate the associated risk factors of anti-osteoporosis drug use in elderly hip fracture patients.Methods Osteoporotic fractures patients in 594 hospitals in 31 provinces/autonomous regions/municipalities were investigated using a multistage,cluster-based,cross-sectional survey method.The present study included patients over 60 years old who underwent hip fracture surgery.The basic information of patients and fracture management information in hospitals were collected.Multivariate logistic regression was applied to identify risk factors associated with anti-osteoporosis drug use.Results This study included 4 369 patients,with a mean age of 76.49±8.78 years.The proportion of anti-osteoporosis drug use was 21.8％.Associated risk factors of anti-osteoporosis drug use included:region(south China vs east China,OR=0.64,95％CI:0.45-0.91;central China vs east China,OR=0.50,95％CI:0.37-0.68),hospital category(general hospitals vs specialized hospitals,OR=1.77,95％CI:1.22-2.57),annual household income(100 000-200 000 CNY vs＜100 000 CNY,OR=1.48,95％CI:1.21-1.82;200 000-300 000 CNY vs＜100 000 CNY,OR=2.11,95％CI:1.51-2.94;＞300 000 CNY vs＜100 000 CNY,OR=2.14,95％CI:1.48-3.09),patients with concomitant pneumonia(OR=1.99,95％CI:1.43-2.78),patients with concomitant stroke(OR=0.65,95％CI:0.45-0.93),patients with concomitant eye disease(OR=1.84,95％CI:1.10-3.06),history of fracture risk assessment(OR=1.40,95％CI:1.02-1.93),osteoporosis knowledge(OR=1.26,95％CI:1.06-1.50),calcium or vitamin D supplements(OR=5.32,95％CI:4.18-6.76),and bone mineral density testing(OR=2.94,95％CI:2.46-3.51).Conclusion The proportion of anti-osteoporosis drug use is low in elderly hip fractures patients.Risk factors associated with anti-osteoporosis drug use are region,hospital category,annual household income,comorbidities,history of fracture risk assessment,osteoporosis knowledge,calcium or vitamin D supplements,and bone mineral density testing.
宋咪;邱晨;邵梦琪;吕厚辰;高远;皮红英
解放军医学院,北京 100853解放军总医院第四医学中心骨科医学部,北京 100853解放军总医院第四医学中心骨科医学部,北京 100853||国家骨科与运动康复临床医学研究中心,北京 100853解放军总医院第一医学中心护理部,北京 100853解放军总医院卫勤训练中心,北京 100853
临床医学
老年人髋部骨折骨质疏松症危险因素抗骨质疏松药物
agedhip fractureosteoporosisrisk factorsanti-osteoporosis drug
《解放军医学院学报》 2024 (005)
469-474 / 6
国家自然科学基金项目(72204262);国家重点研发计划(2022YFC2504300);中国科协办公厅2023年调研课题
评论