探討老人髖部骨折相關危險因子之病歷對照研究

Case-Control Study of Risk Factors for Hip Fracture in the Elderly

背景：台灣地區人口於2008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。目的：利用病歷對照研究方法，以病歷回溯及電話訪問方式收集受試者資料，藉以探討老人的性別、年齡、身體質量指數、生活型態、及疾病史等等是否為髖部骨折的相關危險因子。方法：病歷對照研究，採病歷回溯及電話問卷方式收集資料，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：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）。結論／實務應用 經由研究結果了解髖部骨折之相關危險因子，並提供預防及衛生教育之參考依據，從根本處著手來降低髖部骨折之發生機率，以減少醫療及社會成本支出且提升老人的日常生活品質。

Background: The elderly (≥ 65 years of age) accounted for 10.4% of Taiwan's population in 2008. Hip-fracture-related hospitalizations cost the National Health Insurance Bureau around NT$1.3 billion annually. Hip fractures currently account for one-fifth of all fractures, and this proportion has been rising by 2.8 % annually. Hip fracture-associated mortality has been reported as 8.4-36% during the first post-fracture year. Hip fractures in the elderly is an issue that deserves further elucidation and study.Purpose: We investigated whether variables including gender, age, body mass index, lifestyle, and medical history were risk factors for elderly hip fractures.Methods: We used a case control study and collected data via retrospective chart review and telephone questionnaires. Hip fracture risk factor data collected included demographic, lifestyle, and medical history data.Results: Results showed average age in the hip fracture group as significantly higher than the non-hip fracture group and body mass index as significantly lower in the hip fracture than the non-hip fracture group (p＜ .05). Gender, history of alcoholism, exercise habits, history of stroke, diabetes mellitus, hypertension, depression, and past fractures were identified as significant hip fracture risk factors.Conclusions / Implications for Practice: This study identified critical hip fracture risk factors in the elderly. Results provide a reference for prevention and health education. Reducing hip fractures, in addition to improving daily life quality for elderly individuals, can significantly reduce medical and social expenses.