Abstract
This study aimed to investigate the epidemiology of low-energy lower-extremity fracture in Chinese men and women aged 50 years and above. This study was a part of Chinese National Fracture Survey (CNFS), which used the stratified multistage cluster random sampling method to recruit subjects between January and May 2015. A total of 512187 individuals participated in the CNFS and of them there were 154099 men and women aged 50 years and above included in this study for data analysis. Low-energy fracture was defined as a fracture caused by slip, trip or fall from standing height. Univariate analyses and gender-based multivariate logistic regression models were constructed to identify the independent risk factors. A total of 215 patients had sustained low-energy lower extremity fractures in 2014, indicating the overall incidence was 139.5 (120.9 to 158.2) per 100000 persons, with 127.8 (102.5 to 153.1) and 151.1 (123.8 to 178.5) per 100000 person-year in men and women. Over 80% of fractures occurred at home and on the common road. In men, alcohol consumption (OR, 2.00; 95%CI, 1.29 to 3.08), sleep duration<7h/d (OR, 2.60; 95%CI, 1.68 to 4.03) and history of past fracture (OR, 2.57; 95%CI, 1.33 to 4.95) were identified as significant risk factors associated with low-energy fractures. In women, advanced age (80+ years) (OR, 3.22; 95%CI, 1.80 to 5.75), alcohol consumption(OR, 1.72; 95%CI, 1.00 to 2.98), sleep duration <7h/d (OR, 2.11; 95%CI, 1.40 to 3.18), and history of past fracture (OR, 3.46; 95%CI, 1.97 to 6.09) were identified as significant risk factors and living in western region (OR, 0.60; 95%CI, 0.38 to 0.94) and current weight of 50 to 59.9 kg (OR, 0.17; 95%CI, 0.04 to 0.73) were identified as protective factors for fractures. Accordingly, awareness on the importance of sleep and alcohol consumption on fragility fracture should be improved, and health policies that focus on decreasing alcohol consumption and encouraging individuals to improve their sleep quality and duration should be considered. Maintaining a healthy bodyweight for women should be specifically emphasized to prevent low-energy fractures.
Highlights
Osteoporosis-related fracture comprises a major part of public health care cost in the worldwide, and is associated high morbidity and mortality [1,2,3]
It is predictable that this figure will increase dramatically in the decade and and the challenge from medical care costs is enormous for Chinese health policy-making institutions
We aimed to report the national population-based incidence rate of low-energy lower extremity fracture for overall populations and for different subgroups stratified by age, gender and et al; and to investigate the independent risk factors, in term of demographics, socioeconomics, geographical locations and individual lifestyles
Summary
Osteoporosis-related fracture comprises a major part of public health care cost in the worldwide, and is associated high morbidity and mortality [1,2,3]. Investigation of epidemiologic characteristics of these low-energy fractures is the fundamental task to develop public health programs. By use of these data on age- and gender specific incidence rates and the associated risk factors, we are able to adjust future policy, take preventive measures and optimize management in health care. Most epidemiologic reference data currently used by Chinese studies or policy-making institutions were from foreign researches. Data of such might not be applicable to our Chinese populations, due to the differences in ethnic origins, economic development and individual lifestyles between China and other countries. Most of previous studies focused on a single hospital, several hospitals in a region or populations of a certain subgroup [10,11,12], often reporting diverse incidence rates of low-energy fracture and controversial results for a certain risk factor
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