Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study
- PDF / 664,462 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 51 Downloads / 209 Views
RESEARCH ARTICLE
Open Access
Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study Kuang-Ting Yeh1,2, Tzai-Chiu Yu1,2, Ru-Ping Lee3, Jen-Hung Wang4, Kuan-Lin Liu1,2, Cheng-Huan Peng1, Hao-Wen Chen1, Ing-Ho Chen1,2, Chung-Yi Hsu5 and Wen-Tien Wu1,2,3*
Abstract Background: Osteoporotic hip fracture is a common general health problem with a significant impact on human life because it debilitates the patients and largely decreases their quality of life. Early prevention of fractures has become essential in recent decades. This can be achieved by evaluating the related risk factors, as a reference for further intervention. This is especially useful for the vulnerable patient group with comorbidities. Hepatic encephalopathy (HE), a major complication of liver cirrhosis, may increase the rate of falls and weaken the bone. This study evaluated the correlation between hepatic encephalopathy and osteoporotic hip fracture in the aged population using a national database. Methods: This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012. We included people who were older than 50 years with hepatic encephalopathy or other common chronic illnesses. Patients with and without hepatic encephalopathy were matched at a ratio of 1:4 for age, sex, and index year. The incidence and hazard ratios of osteoporotic hip fracture between the both cohorts were calculated using Cox proportional hazard regression models. Results: The mean age of the enrolled patients was 66.5 years. The incidence ratio of osteoporotic hip fracture in the HE group was significantly higher than that in the non-HE group (68/2496 [2.7%] vs 98/9984 [0.98%]). Patients with HE were 2.15-times more likely to develop osteoporotic hip fractures than patients without HE in the whole group. The risk ratio was also significantly higher in female and older individuals. The results were also similar in the comorbidity subgroups of hypertension, diabetes mellitus, hyperlipidemia, senile cataract, gastric ulcer, and depression. Alcohol-related illnesses seemed to not confound the results of this study. Conclusions: HE is significantly associated with an increased risk of osteoporotic hip fractures, and the significance is not affected by the comorbidities in people aged more than 50 years. The cumulative risk of fracture increases with age. Keywords: Nationwide cohort study, Hepatic encephalopathy, Osteoporotic hip fracture, Propensity score, Kaplan– Meier method
* Correspondence: [email protected] 1 Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan 2 School of Medicine, Tzu Chi University, Hualien, Taiwan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate cr
Data Loading...
