Summary

We investigated the association between hip fracture incidence and living area characteristics in France. The spatial distribution of hip fracture incidence was heterogeneous and there was a significant relationship between social deprivation, urbanization, health access, and hip fracture risk.

Introduction

Several studies have shown great disparities in spatial repartition of hip fractures (HF). The aim of the study was to analyze the association between HF incidence and characteristics of the living area.

Methods

All patients aged 50 or older, living in France, who were hospitalized for HF between 2012 and 2014 were included, using the French national hospital discharge database. Standardized incidence ratio (SIR) was calculated for each spatial unit and adjusted on age and sex. An ecological regression was performed to analyze the association between HF standardized incidence and ecological variables. We adjusted the model for neighborhood spatial structure. We used three variables to characterize the living areas: a deprivation index (French-EDI); healthcare access (French standardized index); land use (percentage of artificialized surfaces).

Results

A total of 236,328 HF were recorded in the French hospital national database, leading to an annual HF incidence of 333/100,000. The spatial analysis revealed geographical variations of HF incidence with SIR varying from 0.67 (0.52; 0.85) to 1.45 (1.23; 1.70). There was a significant association between HF incidence rates and (1) French-EDI (trend p = 0.0023); (2) general practitioner and nurse accessibility (trend p = 0.0232 and p = 0.0129, respectively); (3) percentage of artificialized surfaces (p < 0.0001).

Conclusion

The characteristics of the living area are associated with significant differences in the risk of hip fracture of older people.

中文翻译：

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髋部骨折和生活区特征：法国的精细空间分析。

概括

我们调查了法国髋部骨折发生率与生活区特征之间的关系。髋部骨折发生率的空间分布具有异质性，社会剥夺、城市化、健康可及性和髋部骨折风险之间存在显着关系。

介绍

几项研究表明髋部骨折（HF）的空间重新分配存在很大差异。该研究的目的是分析心衰发病率与生活区特征之间的关联。

方法

使用法国国家医院出院数据库，包括所有 50 岁或以上、居住在法国、在 2012 年至 2014 年期间因心衰住院的患者。计算每个空间单位的标准化发病率 (SIR)，并根据年龄和性别进行调整。进行生态回归以分析 HF 标准化发病率与生态变量之间的关联。我们调整了邻域空间结构的模型。我们使用三个变量来描述生活区：剥夺指数（French-EDI）；医疗保健访问（法国标准化指数）；土地利用（人造表面的百分比）。

结果

法国医院国家数据库共记录了 236,328 例 HF，导致每年 HF 发病率为 333/100,000。空间分析揭示了 HF 发病率的地理差异，SIR 从 0.67（0.52；0.85）到 1.45（1.23；1.70）不等。HF 发病率与 (1) French-EDI 之间存在显着关联（趋势p  = 0.0023）；(2) 全科医生和护士的可及性（趋势分别为p  = 0.0232 和p  = 0.0129）；(3) 人工化表面的百分比 ( p  < 0.0001)。

结论

居住区的特点与老年人髋部骨折风险的显着差异有关。