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      Clinical Interventions in Aging (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on prevention and treatment of diseases in people over 65 years of age. Sign up for email alerts here.

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      Characteristics of Fall-Related Fractures in Older Adults with Cerebrovascular Disease: A Cross-Sectional Study

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          Abstract

          Purpose

          Limited information exists on fall-related fractures in older adults with cerebrovascular disease. This study aimed to determine the characteristics of older adults with cerebrovascular disease who sustained fall-related fractures and identify the associated risk factors for perioperative complications.

          Patients and Methods

          This was a cross-sectional study, which included patients with cerebrovascular disease who sustained fractures between Jan. 2017 and Dec. 2019. The collected data included demographics (age and gender), time and place of fracture occurrence, mechanism of injury, fracture location, type of cerebrovascular disease, complications, and comorbidities.

          Results

          A total of 768 patients with 815 fractures were included; there were 253 males and 515 females, with an average age of 78.3 years. For either males or females, 80–84 years was the most commonly involved age group. Most (61.0%) patients had their fractures occurring at home and most fractures (70.7%) occurred during the daytime. Most were hip fractures and limb weakness; instability-related falls were the most common cause of fracture, making a proportion of 34.5%. Patients who suffered falls were mainly combining ischemic cerebrovascular disease. Most (85.9%) patients presented with at least one comorbid disease and the perioperative complication rate was 76.9% in total cases. Age≥80 (OR: 1.772, 95% CI: 1.236–2.540) and the number of comorbidities≥3 (OR: 1.606, 95% CI: 1.035–2.494) were found independently associated with complications, while the type of cerebrovascular disease, fracture location, and comorbidities of prior fragility fracture and respiratory disease were not significantly correlated with complications.

          Conclusion

          Our findings highlighted that more focus on improved physical function explored in intervention setting and the importance of primary home prevention measures seems justified in China and maybe other countries as well. It is the first study that presented the epidemiological characteristics of older adults with cerebrovascular disease who later experienced a fracture.

          Most cited references32

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          Prevalence, Incidence, and Mortality of Stroke in China: Results from a Nationwide Population-Based Survey of 480 687 Adults.

          China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the past 30 years.
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            Incidence and mortality of hip fractures in the United States.

            Understanding the incidence and subsequent mortality following hip fracture is essential to measuring population health and the value of improvements in health care. To examine trends in hip fracture incidence and resulting mortality over 20 years in the US Medicare population. Observational study using data from a 20% sample of Medicare claims from 1985-2005. In patients 65 years or older, we identified 786,717 hip fractures for analysis. Medication data were obtained from 109,805 respondents to the Medicare Current Beneficiary Survey between 1992 and 2005. Age- and sex-specific incidence of hip fracture and age- and risk-adjusted mortality rates. Between 1986 and 2005, the annual mean number of hip fractures was 957.3 per 100,000 (95% confidence interval [CI], 921.7-992.9) for women and 414.4 per 100,000 (95% CI, 401.6-427.3) for men. The age-adjusted incidence of hip fracture increased from 1986 to 1995 and then steadily declined from 1995 to 2005. In women, incidence increased 9.0%, from 964.2 per 100,000 (95% CI, 958.3-970.1) in 1986 to 1050.9 (95% CI, 1045.2-1056.7) in 1995, with a subsequent decline of 24.5% to 793.5 (95% CI, 788.7-798.3) in 2005. In men, the increase in incidence from 1986 to 1995 was 16.4%, from 392.4 (95% CI, 387.8-397.0) to 456.6 (95% CI, 452.0-461.3), and the subsequent decrease to 2005 was 19.2%, to 369.0 (95% CI, 365.1-372.8). Age- and risk-adjusted mortality in women declined by 11.9%, 14.9%, and 8.8% for 30-, 180-, and 360-day mortality, respectively. For men, age- and risk-adjusted mortality decreased by 21.8%, 25.4%, and 20.0% for 30-, 180-, and 360-day mortality, respectively. Over time, patients with hip fracture have had an increase in all comorbidities recorded except paralysis. The incidence decrease is coincident with increased use of bisphosphonates. In the United States, hip fracture rates and subsequent mortality among persons 65 years and older are declining, and comorbidities among patients with hip fractures have increased.
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              National incidence of traumatic fractures in China: a retrospective survey of 512 187 individuals.

              Traumatic fractures place a substantial burden on health-care systems worldwide. Although detailed information about incidence, distribution, and risk factors for traumatic fractures is vital for planning and prevention, in China, national data are unavailable. We aimed to do an up-to-date national survey on the population-weighted incidence of traumatic fractures in China.
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                Author and article information

                Journal
                Clin Interv Aging
                Clin Interv Aging
                cia
                clinintag
                Clinical Interventions in Aging
                Dove
                1176-9092
                1178-1998
                13 July 2021
                2021
                : 16
                : 1337-1346
                Affiliations
                [1 ]Department of Geriatric Orthopedics, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, People’s Republic of China
                [2 ]Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, 050051, People’s Republic of China
                [3 ]NHC Key Laboratory of Intelligent Orthopeadic Equipment (The Third Hospital of Hebei Medical University) , Shijiazhuang, Hebei, 050051, People's Republic of China
                [4 ]Chinese Academy of Engineering , Beijing, 100088, People’s Republic of China
                Author notes
                Correspondence: Zhiqian Wang Department of Geriatric Orthopedics, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, 050051, People’s Republic of China Email w18533112890@163.com
                Zhiyong Hou Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, 050051, People’s Republic of China Email drzyhou@gmail.com
                [*]

                These authors contributed equally to this work

                Article
                316739
                10.2147/CIA.S316739
                8286076
                34285478
                9d903472-2952-4a5b-9722-d94b9210c3f8
                © 2021 Fu et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 20 April 2021
                : 25 June 2021
                Page count
                Figures: 2, Tables: 6, References: 32, Pages: 10
                Funding
                Funded by: Department of Finance Geriatric Disease Prevention and Control;
                The study was financially supported by the 2019 Hebei Provincial Department of Finance Geriatric Disease Prevention and Control Funds.
                Categories
                Original Research

                Health & Social care
                cross-sectional study,epidemiology,fall-related fracture,cerebrovascular disease,older adults

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