title: Chronic Obstructive Pulmonary Disease Increases the Risk of Hip Fracture: A Nationwide Population-Based Cohort Study.
abstract: Hip fractures can lead to functional disability and high mortality rates among elderly patients. The aim of this study was to investigate whether chronic obstructive pulmonary disease (COPD) is a risk factor for hip fracture. A retrospective population-based 4-year cohort study was conducted using case-control matched analysis of data from the Taiwan Longitudinal Health Insurance Database 2005 (LHID2005). Patients with a diagnosis of COPD between January 1, 2004 and December 31, 2007 were enrolled. A 2-stage approach and data from the National Health Interview Survey 2005 were applied to adjust for missing confounders in the LHID2005 cohort. Hazard ratios (HRs) and adjusted HRs were estimated hip fracture risk for the COPD. We enrolled 16,239 patients in the COPD cohort and 48,747 (1:3) patients in non-COPD cohort. The hip fracture incidences were 649 per 100,000 person-years in the study cohort and 369 per 100,000 person-years in non-COPD cohort. The hip fracture HR during the follow-up period was 1.78 (P < 0.001) and the adjusted hip fracture HR was 1.57 (P < 0.001) after adjustment for covariates by using the 2-stage approach method. Patients with COPD were at hip fracture risk and fracture-prevention strategies are essential for better quality of care.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.|Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Huang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Wei-Te
authors.initials: WT
authors.lastname: Wang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Lin-Chuan
authors.initials: LC
authors.lastname: Chou
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.|Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hung-Chou
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.|Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.|Graduate Institute of Injury Prevention, Taipei Medical University, Taipei, Taiwan.
authors.forename: Tsan-Hon
authors.initials: TH
authors.lastname: Liou
authors.affiliation: Department of Mathematics, Soochow University, Taipei, Taiwan.|Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hui-Wen
authors.initials: HW
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D011787:Quality of Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology