Epidemiology of low-energy lower extremity fracture in Chinese populations aged 50 years and above

• Published in: PloS one Vol. 14; no. 1; p. e0209203
• Main Authors: Zhu, Yanbin, Liu, Song, Chen, Wei, Liu, Bo, Zhang, Fei, Lv, Hongzhi, Ji, Chenni, Zhang, Xiaolin, Zhang, Yingze
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.01.2019; Public Library of Science (PLoS)
• Subjects: Accidental Falls - statistics & numerical data; Age; Age Factors; Aged; Aged, 80 and over; Alcohol; Alcohol Drinking - adverse effects; Alcohol use; Alcohols; Animals; Biology and Life Sciences; Biomechanics; Cats; Chen, Wei; China - epidemiology; Data analysis; Data collection; Data processing; Elderly; Energy; Epidemiology; Female; Fractures; Fractures (Injuries); Fractures, Bone - epidemiology; Fragility; Health aspects; Health care; Health policy; Humans; Incidence; Laboratories; Leg Injuries - epidemiology; Lifestyles; Logistic Models; Logistic regression; Male; Medicine and Health Sciences; Men; Methods; Multivariate Analysis; Older people; Osteoporosis; People and Places; Population; Prevention; Public health; Questionnaires; Random sampling; Regression analysis; Regression models; Risk analysis; Risk Factors; Sampling (Statistics); Sampling methods; Sleep; Sleep Wake Disorders - complications; Statistical sampling; Studies; Surgery; Surveys and Questionnaires; Systematic review; Weight; Women; China; Beijing China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0209203

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.