Abstract:

Objective To explore influencing factors of subsequent fracture among elderly osteoporotic patients and provide a basis for improving the management and early intervention after osteoporotic fracture. Methods A total of 14 349 elderly patients with osteoporotic fracture in 594 hospitals across 31 provinces（autonomous regions and municipalities） were selected by convenience sampling method from September to December 2023. A general information questionnaire and a clinical characteristics of fracture questionnaire were used. The univariate analysis and logistic regression were used to clarify the influencing factors and gender differences. Results A total of 11 364 valid questionnaires were collected，with a valid questionnaire recovery rate of 79.20%. Gender，age，occupation，education，marital status，family history of osteoporosis，comorbid osteoarthropathies/rheumatism/ophthalmopathies，bone mineral density，risk of fall，risk of fracture grade，reasons and site for first fracture, whether to use walking aid and receive home rehabilitation guidance were associated with the occurrence of subsequent fracture. Gender comparisons found that widowhood，family history of osteoporosis，comorbid rheumatism，vertebral fracture，alcohol consumption，fall or no causative factor triggering the fracture，and educational level，home rehabilitation instruction were associated with the risk of subsequent fracture only in women（P<0.05）. Smoking was associated with the risk of subsequent fracture only in men（P<0.05）. Conclusion Osteoporotic subsequent fracture in the elderly is affected by multidimensional factors，with significant gender differences. The surveillance of key populations should be strengthened in prevention，control and intervention.

Key words: Osteoporotic Fracture, Subsequent Fracture, Aged, Root Cause Analysis, Nursing Care

摘要：

目的 了解老年骨质疏松性骨折患者再骨折影响因素，为完善骨质疏松性骨折后管理及早期干预提供依据。方法 采用便利抽样法，于2023年9月—12月选取31个省（区、市）594所医院的14 349例老年骨质疏松性骨折住院患者作为调查对象，采用一般资料调查表、骨折临床特征调查表进行调查，采用单因素分析及Logistic回归明确再骨折的影响因素及性别差异。结果 共回收有效问卷11 364份，有效问卷回收率为79.20%。性别、年龄、退休前职业状态、文化程度、婚姻状况、骨质疏松家族史、合并骨关节疾病/风湿病/眼病、骨密度、骨折风险等级、首次骨折原因及部位、是否使用助行器和接受居家康复指导与老年骨质疏松性骨折患者再骨折发生有关。性别比较发现，丧偶、骨质疏松家族史、合并风湿病、椎体骨折、饮酒、跌倒或无诱因引发骨折、文化程度、居家康复指导仅与女性老年骨质疏松性骨折患者再骨折风险相关（P<0.05）。吸烟仅与男性老年骨质疏松性骨折患者再骨折风险相关（P<0.05）。结论 老年人骨质疏松性骨折患者再骨折受多种因素影响，性别差异显著，在防控与干预中应加强重点人群监测。

关键词: 骨质疏松性骨折, 再骨折, 老年人, 影响因素分析, 护理