Yaşlılarda karşı taraf ikinci kalça kırığı için başlıca risk faktörleri

Amaç: Bu çalışmada, yaşlılarda ilk kalça kırığına zemin hazırlayan risk faktörlerinden hangilerinin ikinci kalça kırığı gelişimi için de risk faktörü olmayı sürdürdüğünün belirlenmesi amaçlandı. Çalışma planı: Yaşları 55 veya daha yukarı olan, kalça kırıklı 125 hastanın (31 erkek, 94 kadın) verileri değerlendirildi. Doksan yedi hastada kalça kırığı ilk kez, 28 hastada karşı taraf kalçada ikinci kez kırık oluşmuştu. Bifosfonat, kalsitonin ve östrojen tedavisi gören hastalar çalışmaya alınmadı. Sonuçlar: İkinci kalça kırığı çoğunlukla (%78.6) ilk kırıktan 12 ay sonraki dönemde meydana gelmişti. Seksen beş yaş üzeri hastalarda ikinci kırık riski 3.96 kat artmış bulundu (p

Anahtar Kelimeler:

Düşme kazaları, Kalça kırıkları, Yaş faktörü, Tekrarlama, Risk faktörleri, Odds oranı, İşlevsel lateralizasyon

Major risk factors for the second contralateral hip fracture in the elderly

Objectives: The purpose of this study was to determine which of the predisposing risk factors for the ﬁrst hip fracture would continue to be effective for the development of the second hip fracture in the elderly. Methods: Data of 125 patients (31 men, 94 women) aged 55 years or older were evaluated, who sustained ﬁrst (group 1, n=97) and second contralateral (group 2, n=28) hip fracture. Patients who were treated with bisphosphonate, calcitonin, and estrogen were not included. Results: The incidence of the second hip fracture was higher (78.6%) beyond 12 months of the ﬁrst fracture. The risk for sustaining a second hip fracture was 3.96-fold greater in patients over 85 years of age (p<0.05). Among comorbid medical conditions, eye diseases (p=0.02) and neurological diseases (p=0.048) were seen signiﬁcantly more frequent in group 2. There was an obvious relationship between the second hip fracture and lower Singh index grades of ≤3 (p<0.001). Patients over 85 years of age and having a lower Singh index grade were found to have a 6.57-fold increased risk for developing a second hip fracture (95% CI: 2.13-20.3; p=0.001). In univariate analysis, neurological diseases represented a signiﬁcantly increased risk. Eye diseases were highly associated with an increased risk for second hip fractures in univariate (OR: 3.3, 95% CI: 1.2-9.2, p=0.020) and multivariate (OR: 7.6, 95% CI: 1.9-30.7, p=0.004) analyses. The Singh index of grade ≤3 showed the highest associations with second hip fractures in both univariate (OR: 18.9, 95% CI: 5.8-65.9, p<0.001) and multivariate (OR: 30.00, 95% CI: 7.9-112.9, p<0.001) analyses. Conclusion: We concluded that, of all the risk factors for the ﬁrst hip fractures, only hypotrophic changes in the proximal femoral trabeculae, eye diseases, and neurological diseases acted as major risk factors for the second contralateral hip fractures in the elderly.

Keywords:

Accidental Falls, Hip Fractures, Age Factors, Recurrence, Risk Factors, Odds Ratio, Functional Laterality,

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