Single-center Epidemiological Study Of Early-onset And Recurrent Hip Fractures

Objective: Exploring some epidemiological characteristics of Initial and recurrent hip fractures in Dalian elderly people.To some extent,it can make up for the lack of epidemiological data on the early-onset and recurrent hip fractures in China and even in Asia.And it can provide a theoretical basis for the prevention of hip fracture and secondary hip fracture in Dalian.Methods:A retrospective study of 952 patients with hip fractures aged 60 or older who admitted to the Department of Trauma and Orthopaedics,the First Affiliated Hospital of Dalian Medical University from January 2010 to December 2017,including 277 males(29.1%)and 675 females(70.9%).Aged 60 to 101,average(71.2 ± 9.7)years old.I recorded their gender,age,fracture type,fracture seasons,hospitalization costs and so on and called by phone and clinical follow-up.And I observed the distribution characteristics of hip fractures in different ages and genders.I analyzed the hip fracture type,morbidity,seasonal relationship,hospitalization costs change,recurrent time of hip fracture,and post-fracture mortality.Statistical analysis was performed by SPSS19.0.The t-test was used for comparison between groups.And P<0.05 was considered statistically significant.Results:There were 897 successful cases(94.2%)and 55 cases(5.8%)were lost for follow-up,of which 799(89.1%)were treated surgically and 98(10.9%)were treated conservatively.1.There were 897 cases of initial hip fracture,the ratio of male to female was 1:2.5,and the average age was(77.1±9.6)years old.There were 55 hip fractures,the ratio of male and female was 1:5.9,and the average age was(83.0 ± 6.7)years old.There were significantly more women than men,and the differences were statistically significant(P<0.05).The age of recurrent hip fracture was significantly higher than that of the initial hip fracture,and the difference was statistically significant(P<0.05).2.Initial hip fractures were concentrated in 70 ~89 years old;recurrent hip fractures were concentrated in 80~89 years old.3.After the initial femoral neck fracture,the rate of recurrent hip fracture was still56.7% of the femoral neck fracture.The rate of recurrent hip fracture after initial femoral intertrochanteric fracture was 73.9%.4.Initial hip fractures generally increased at an average annual rate of 4.6%.The initial femoral neck fractures increased at an average annual rate of 9.7%,and the initial intertrochanteric fractures increased at an average annual rate of 1.8%.The difference was statistically significant(P<0.05).There was no significant difference in the incidence of recurrent hip fractures(P>0.05).5.The incidence of hip fractures in winter was significantly higher than that in other seasons,and the difference was statistically significant(P<0.05).6.The total annual hospitalization costs for hip fractures increased from 430,253.154 yuan in 2010 to 807,301.10 yuan in 2017.The total costs of hip fractures in 2017 was1.9 times that of 2010,grew at an average annual rate of 9.41%.The annual per capita hospitalization costs for hip fractures increased from 43691.93 yuan in 2010 to60007.68 yuan in 2017,grew about 1.4 times compared with 2010,and an average annual growth rate of 4.6%.The per capita hospitalization costs of femoral neck fractures increased at an average annual rate of 6.99%.The per capita hospitalization costs of femoral intertrochanteric fractures increased at an average annual rate of 2.84%.7.The incidence of recurrent hip fracture was 6.1%.The hip fracture was the most common one within 1 year after fracture,accounting for 23.6%.The hip fracture was gradually decreased with the prolongation of the initial hip fracture.The difference was statistically significant(P <0.05).8.In the early eight years,the mortality rate of hip fracture was 16.5%,and the mortality rate of hip fracture was 5.5%.The mortality rate of the first year after initial hip fracture was 6.8%.After that,the mortality decreased significantly with time(P<0.05).Conclusions:1.The incidence of hip fracture in elderly women in Dalian is more than that in men.The initial hip fractures are concentrated in 70~89 years old,and the recurrent hip fractures are concentrated in 80~89 years old.2.There is a high incidence of hip fracture in winter.3.The incidence of hip fracture and hospitalization costs increase slowly year by year.4.The type of hip fracture that occurs after the initial intertrochanteric fracture is mostly intertrochanteric fracture.5.The fracture and the highest mortality rate occur in the first year of the initial hip fracture.