METHODS: Five databases MEDLINE, PUBMED, EMBASE, Web of Science and the Cochrane Library were searched to identify studies that reported mortality following hospitalisation for low-trauma hip fracture in adults aged ≥50 years with data from 2010 to 30 September 2021. There were no restrictions on study design or language. Pooled mortality estimates for countries/regions with ≥2 studies were calculated using random-effects models.
RESULTS: In total 244 studies were included in the meta-analysis. 123 studies (1,382,810 patients, 13 countries/regions) reported in-hospital mortality which ranged from 1.4 % in Japan [95 %CI 1.2-1.7], Singapore [95 %CI 1.0-1.6], China [95 %CI 0.8-2.3] and Hong Kong SAR [95 %CI 0.8-2.6] to 5.5 % [95 %CI 4.1-7.2] in New Zealand. 92 studies (628,450 patients, 13 countries/regions) reported 30-day mortality which ranged from 1.2 % in Japan [95 %CI 0.9-1.5] and Thailand [95 %CI 0.7-2.0] to 7.4 % [95 %CI 7.0-7.8] in Australia. 142 studies (1,139,752 patients, 14 countries/regions) reported 1-year mortality which ranged from 10.8 % [95 %CI 9.6-12.1] in Singapore to 23.3 % [95 %CI 22.3-24.5] in Australia and 23.8 % in New Zealand.
CONCLUSIONS: There is substantial variation in mortality across the Asia Pacific region. Short-term mortality rates in Asian countries, notably Japan and Singapore, are up to four-fold lower than for Australia and New Zealand. This difference, although less marked, is sustained at 1-year with a two-fold lower mortality rate in Asia. This meta-analysis is the first to delineate these differences, further studies are required to understand the reasons for this variation.
方法:五个数据库MEDLINE,pubmed,EMBASE,搜索了WebofScience和Cochrane图书馆,以确定报告年龄≥50岁的成年人低创伤髋部骨折住院后死亡率的研究,数据为2010年至2021年9月30日。对研究设计或语言没有限制。使用随机效应模型计算≥2项研究的国家/地区的汇总死亡率估计值。
结果:共有244项研究纳入荟萃分析。123项研究(1,382,810名患者,13个国家/地区)报告的住院死亡率在日本为1.4%[95CI1.2-1.7],新加坡[95CI1.0-1.6],中国[95CI0.8-2.3]和香港特别行政区[95CI0.8-2.6]至新西兰的5.5%[95CI4.1-7.2]。92项研究(628,450名患者,13个国家/地区)报告了30天死亡率,在日本[95CI0.9-1.5]和泰国[95CI0.7-2.0]为1.2%,在澳大利亚为7.4%[95CI7.0-7.8]。142项研究(1,139,752例患者,14个国家/地区)报告的1年死亡率从新加坡的10.8%[95CI9.6-12.1]到澳大利亚的23.3%[95CI22.3-24.5]和新西兰的23.8%。
结论:亚太地区的死亡率差异很大。亚洲国家的短期死亡率,尤其是日本和新加坡,比澳大利亚和新西兰低四倍。这种差异,虽然不太明显,持续1年,亚洲的死亡率降低了两倍。这项荟萃分析是第一个描述这些差异的方法,需要进一步的研究来了解这种变化的原因。