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  

Status of and factors associated with anti-osteoporosis drug use among elderly patients with hip fracture:A nationwide cross-sectional study

作　　者：宋咪 邱晨 邵梦琪 吕厚辰[2,3] 高远 皮红英[5] SONG Mi;QIU Chen;SHAO Mengqi;LYU Houchen;GAO Yuan;PI Hongying(Chinese PLA Medical School,Beijing 100853,China;Department of Orthopedics,the Fourth Medical Center,Chinese PLA General Hospital,Beijing 100853,China;National Clinical Research Center for Orthopedics,Sports Medicine&Rehabilitation,Beijing 100853,China;Department of Nursing,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Military Health Service Training Center,Chinese PLA General Hospital,Beijing,100853,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第四医学中心骨科医学部,北京100853 [3]国家骨科与运动康复临床医学研究中心,北京100853 [4]解放军总医院第一医学中心护理部,北京100853 [5]解放军总医院卫勤训练中心,北京100853

出　　处：《解放军医学院学报》2024年第5期469-474,共6页Academic Journal of Chinese PLA Medical School

基　　金：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。

摘　　要：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4369例老年髋部骨折患者纳入研究,其中女性3000例,男性1369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 4369 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(100000-200000 CNY vs<100000 CNY,OR=1.48,95%CI:1.21-1.82;200000-300000 CNY vs<100000 CNY,OR=2.11,95%CI:1.51-2.94;>300000 CNY vs<100000 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,histo

关 键 词：老年人 髋部骨折 骨质疏松症 危险因素 抗骨质疏松药物 

分 类 号：R683.42[医药卫生—骨科学]