| Summary: | 碩士 === 中山醫學院 === 醫學研究所 === 85 === Mortality after Hip FracturesAbstractBackground: Hip fracture is
an important cause of mortality and morbidityamong the elderly,
leading to direct economic costs in excess of $4 billionper year
in the United States. Because hip fracture incidence rises with
ageand the elderly population will increase dramatically in the
coming decadeswe can expect continued growth in the annual
number of hip fractures.Objective: To compare the hip fracture
incidence and mortality rates with those of Western countries.
To identify the risk factors that associated with mortality
after hip fracture.Materials and Methods: Hip fracture patients
admitted to Chung Shan Medical &Dental College Hospital during
the period of 1992-1996 were collected using discharge data.
Variables of interest included demography, principal
injuriesdiagnoses, E-code, year, type of fracture, type of
operation, time between fracture and operation, number of
comorbid diagoses.Results: Hip fracture rate (per 1000 first
admissins) increasd for males from3.8 for ages 60-64 to 53.1 for
ages 85 and over and for females from 9.4 forages 60-64 to 86.7
for ages 85 and over. The proportion of patients who died were
5.4%, 6.4% and 7.1% within one, three, and 12 months after hip
fracture were respectively. Factors associated with one year
mortality were elder inage, external cause due to falls,
extracapusular fracture type, no peration, and 3 and more
comorbid diagnoses remain statistically significantly, with
relative odds (RO) of dying for those with 3 and more comorbid
diagnosesveresus those with 2 and less were 6.8 with 95%
confidence interval (CI) 1.8-16.4. The RO of dying among
patients with comorbid diagnoses of cardiovascular diseases were
4.7 (95% cI 1.4-16.3). Conclusions: The resultsof the study
suggest that the prevention of hip fracture in elderly
populationand careful treatment of multiple comorbid patients
after hip fracture remain an important challenge to clinicians.
key words: Hip fracture, mortality
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