title: Older male physicians have lower risk of trochanteric but not cervical hip fractures.
abstract: BACKGROUND
  Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures.
  
  
  METHODS
  Data regarding older (≥65 years) physicians (n = 4303) and matched non-medical persons (control) were retrieved from Taiwan's National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR) of hip fracture associated with older physicians.
  
  
  RESULTS
  The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively), whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively). Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37-0.79); by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged.
  
  
  CONCLUSIONS
  Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures.
authors.affiliation: Department of Intensive Care Medicine, Chi Mei Medical Center, No. 901 Chung-Hwa Road, Yong-Kang district, Tainan 71004, Taiwan. chinli.lu@gmail.com.|Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan. chinli.lu@gmail.com.
authors.forename: Hsiu-Nien
authors.initials: HN
authors.lastname: Shen
authors.affiliation: Department of Orthopedics, Chi Mei Medical Center, No. 901 Chung-Hwa Road, Yong-Kang District, Tainan 71004, Taiwan. aapriliaa@gmail.com.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Lin
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan. chinli.lu@gmail.com.|Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539 Zhongxiao East Rd., East district, Chiayi 60002, Taiwan. chinli.lu@gmail.com.
authors.forename: Chin-Li
authors.initials: CL
authors.lastname: Lu
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan. cyli99@mail.ncku.edu.tw.|Department of Public Health, China Medical University, Taichung 40447, Taiwan. cyli99@mail.ncku.edu.tw.
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D016022:Case-Control Studies; D006620:Hip Fractures / Q000145:classification / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology