AAOS：抗骨质疏松治疗可降低髋部骨折老年女性的死亡风险

引言：尽管人们已非常清楚髋部骨折术后早期有较高死亡率的风险，但目前尚无充分证据表明抗骨质疏松治疗是否有助于降低术后死亡率。本研究旨在探讨老年女性患者发生髋部骨折后予以抗骨质疏松治疗与死亡率之间的关系。
方法：我们设计了一项回顾性非盲随机对照研究，以确定老年女性患者因髋部骨折接受手术治疗后接受抗骨质疏松治疗是否有助于降低术后2年的死亡率。总共有255例55岁以上，因低能量损伤导致首次髋部骨折的女性患者符合本研究的纳入标准。将这些病例随机分为3组，第一组为17β-雌二醇凝胶治疗组，1.5g每日一次（n=78），第二组予以利塞膦酸钠治疗组，35mg每周一次（n=84），第三组为对照组，未予以任何抗骨质疏松治疗（n=83）。分别计算两组治疗组病例的1年及2年死亡率，并与对照组死亡率进行比较。
结果：本研究所纳入病例术后1年和2年的总体死亡率分别为6.7%和13.5%。抗骨质疏松治疗病例术后1年总死亡率为4.9%，显著低于对照组（10.8%，p = 0.042）。抗骨质疏松治疗病例术后2年总死亡率为8.5%，同样显著低于对照组（25%，p = 0.017）。但双膦酸盐治疗组病例和激素治疗组病例术后1年和2年的死亡率无显著差异。
讨论和结论：抗骨质疏松治疗能显著降低老年女性髋部骨折术后的死亡率。
与骨质疏松相关的拓展阅读：

• JCEM:早绝经女性易患心脏病和骨质疏松症
• A＆R：萎缩型髋部OA患者发生骨质疏松性骨折的风险高
• Nat Med：骨质疏松症预防治疗研究获突破
• A&R：骨关节炎患者的松质骨抗疲劳损伤性能优于骨质疏松症患者
• RSNA:腹型肥胖男子骨质疏松风险增加
• 口服降钙素预防绝经后骨质疏松症II期试验获阳性结果
更多信息请点击：有关骨质疏松更多资讯

Osteoporosis Treatment Reduces Mortality Risk after Hip Fracture Surgery in Elderly Women
INTRODUCTION
Although premature mortality is well recognized after a hip fracture, there has been lack of clear evidence that osteoporosis treatment may reduce mortality risk. The objective of this study was to investigate the association between osteoporosis medications with mortality in elderly women who had experienced a hip fracture.
METHODS
We conducted a prospective, open label, randomized trial to determine whether osteoporosis medication reduces two-year mortality rate in elderly women after hip fracture surgery. A total of 255 women over 55 years of age with acute, first-time and lower-energy trauma hip fractures met the inclusion criteria. They were randomly assigned to receive 17β-estradiol gel 1.5g daily (n=78) or risedronate 35mg weekly (n=84), and the untreated patients served as control group (n=83). One-year and two-year mortality rates were calculated separately for each treatment group and were compared to the untreated control group.
RESULTS
The overall one-year and two-year mortality rates after hip fracture surgery were 6.7% and 13.5%, respectively. One-year mortality rate of 4.9% in the osteoporosis treatment group was significantly lower than that of 10.8% in the untreated control group (p = 0.042). Two-year mortality rate of 8.5% in the osteoporosis treatment group was significantly lower than that of 25% in the untreated control group (p = 0.017). There was no significant difference of one-year and two-year mortality rates between the bisphosphonate treatment group and the hormone treatment group.
DISCUSSION AND CONCLUSION
Osteoporosis treatment appears to reduce mortality risk in elderly women after hip fracture surgery