探討老人髖部骨折之相關危險因子一個病歷對照研究

台灣地區人口於民國 97 年時，65 歲以上老年人口佔 10.4 %。國內健保每年花在老人髖部骨折之住院費為13億，佔所有骨折的1/5，且每年約增加 2.8% 髖部骨折人口，加上髖部骨折後老人一年內的死亡率高達8.4~ 36％，故老人髖部骨折這議題是不容忽視的。本研究為一病歷對照研究，採病歷回溯及電話問卷方式收集資料，研究對象為中部某醫學中心骨科病房及健檢中心年滿65歲老人，經骨科病房病歷回溯，因低能量傷害(low energy trauma)導致髖部骨折的病患，其編制至A組為- 病歷組；經健檢中心病歷回溯，曾有低能量傷害 (low energy trauma)，但非髖部骨折者，編制至B組為- 對照組，收集其人口學資料、生活型態、疾病藥物史等髖部骨折相關危險因素。結果顯示髖部骨折組之平均年齡大於非髖部骨折組；身體質量指數低於非髖部骨折組，且均有顯著差異 (p <.05)。而病患的性別、生活中有無飲酒、有無運動習慣、有無腦中風病史、有無糖尿病病史、高血壓病史、憂鬱症病史及過去是否曾經骨折都是髖部骨折的重要危險因子 (p <.05)。

The proportion of elderly (65 years of age and older) in Taiwan has accounted for 10% since 2008. The annual hospitalization expense of hip fractures cost the Central Health Insurance Department around 1.3 billion Taiwanese dollars. This accounted for one-fifth of all fractures, and the proportion of the hip fracture is increasing by 2.8 % annually. The mortality rate associated with hip fracture is 8.4 ~ 36% in their first year. Therefore, the subject of hip fracture in the elderly cannot be underestimated.This study was a case control study. Data were collected via retrospective chart review and questionnaires. Research subjects comprised of elderlies above the age of 65 and were taken from an orthopedic ward and a health examination outpatient clinic in a medical center in midland of Taiwan. By reviewing medical records in the orthopedic ward, patients with low energy trauma resulting in hip fractures were placed in Group A (trauma group). By reviewing medical records in the health examination clinic, patients with previous non-hip related low energy trauma were placed in Group B (control group). We collected information related to hip fracture risk factors, including demographic data, lifestyle, and medical history. The results showed that the average age of the hip fracture group is higher than the non-hip fracture group; body mass index of the hip fracture group is lower than the non-hip fracture group, with significant differences (p < .05). Factors including patient gender, history of alcoholism, exercise habits, history of stroke, diabetes mellitus, hypertension, depression and past fractures are the risk factors of hip fracture (all with significant differences).