Sayan K Chatterjee, Ramin Talebi, Ken Kitayama, Andrew G Young, Fei Yu, Victoria L Tseng, Anne L Coleman
{"title":"加利福尼亚州医疗保险受益人青光眼严重程度与髋部骨折之间的关系。","authors":"Sayan K Chatterjee, Ramin Talebi, Ken Kitayama, Andrew G Young, Fei Yu, Victoria L Tseng, Anne L Coleman","doi":"10.1016/j.ogla.2024.10.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between glaucoma severity and hip fractures in older adults.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Subjects: </strong>California (CA) Medicare beneficiaries in 2019 with Parts A & B coverage.</p><p><strong>Methods: </strong>Multivariable logistic regression was used to analyze the association between glaucoma severity (mild, moderate, and severe vs. no glaucoma) and hip fracture, after adjusting for age, sex, race and ethnicity, and Charlson Comorbidity Index score. A subgroup analysis was performed only in individuals with glaucoma to examine the odds of hip fracture for those with moderate and severe glaucoma compared to those with mild glaucoma.</p><p><strong>Main outcome measures: </strong>The variations in the odds of hip fractures for patients with and without glaucoma and for patients with moderate and severe glaucoma compared to those with mild glaucoma.</p><p><strong>Results: </strong>Of the 2 717 346 beneficiaries in the study population, 220 662 (8.1%) had glaucoma. In multivariable regression analysis, those with mild (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.78-0.88) and moderate glaucoma (OR: 0.88; 95% CI: 0.84-0.92) had reduced odds of hip fracture compared with those with no glaucoma. There was no statistically significant association between severe vs. no glaucoma and hip fracture (OR: 0.96; 95% CI: 0.91-1.02). Among individuals with glaucoma, the odds of hip fracture were higher for those with severe glaucoma (OR: 1.17; 95% CI: 1.08-1.27), compared with those with mild glaucoma.</p><p><strong>Conclusions: </strong>In the CA Medicare population, the presence of glaucoma was associated with decreased likelihood of hip fracture. However, in those with glaucoma, increased glaucoma severity was associated with an increased likelihood of hip fracture. Potential mediating mechanisms requiring further study include fear of falls and physical inactivity in patients with glaucoma.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. 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A subgroup analysis was performed only in individuals with glaucoma to examine the odds of hip fracture for those with moderate and severe glaucoma compared to those with mild glaucoma.</p><p><strong>Main outcome measures: </strong>The variations in the odds of hip fractures for patients with and without glaucoma and for patients with moderate and severe glaucoma compared to those with mild glaucoma.</p><p><strong>Results: </strong>Of the 2 717 346 beneficiaries in the study population, 220 662 (8.1%) had glaucoma. In multivariable regression analysis, those with mild (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.78-0.88) and moderate glaucoma (OR: 0.88; 95% CI: 0.84-0.92) had reduced odds of hip fracture compared with those with no glaucoma. There was no statistically significant association between severe vs. no glaucoma and hip fracture (OR: 0.96; 95% CI: 0.91-1.02). 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引用次数: 0
摘要
目的：研究老年人青光眼严重程度与髋部骨折之间的关系：研究对象：2019 年加州 A 部分和 B 部分医疗保险受益人：采用多变量逻辑回归分析青光眼严重程度（轻度、中度和重度与无青光眼）与髋部骨折之间的关系，并对年龄、性别、种族和民族以及查尔森合并症指数评分进行调整。仅对青光眼患者进行了亚组分析，以研究中度和重度青光眼患者与轻度青光眼患者发生髋部骨折的几率：有青光眼和无青光眼患者髋部骨折几率的变化，以及中度和重度青光眼患者与轻度青光眼患者髋部骨折几率的变化：在 2,717,346 名研究对象中，220,662 人（8.1%）患有青光眼。在多变量回归分析中，与没有青光眼的人相比，患有轻度青光眼（赔率[OR]：0.83，95% 置信区间[CI]：0.78-0.88）和中度青光眼（赔率：0.88，95% 置信区间[CI]：0.84-0.92）的人发生髋部骨折的几率较低。重度青光眼和无青光眼与髋部骨折之间没有明显的统计学关联（OR：0.96，95% CI：0.91-1.02）。在青光眼患者中，与轻度青光眼患者相比，中度青光眼患者（OR：1.07；95% CI：0.99-1.15）和重度青光眼患者（OR：1.17；95% CI：1.08-1.27）发生髋部骨折的几率更高：结论：在加州医疗保险人群中，患有青光眼与髋部骨折的可能性降低有关。然而，在患有青光眼的人群中，青光眼严重程度的增加与髋部骨折可能性的增加有关。需要进一步研究的潜在中介机制包括青光眼患者害怕跌倒和缺乏运动。
The Association between Glaucoma Severity and Hip Fractures in California Medicare Beneficiaries.
Purpose: To examine the association between glaucoma severity and hip fractures in older adults.
Design: Retrospective cross-sectional study.
Subjects: California (CA) Medicare beneficiaries in 2019 with Parts A & B coverage.
Methods: Multivariable logistic regression was used to analyze the association between glaucoma severity (mild, moderate, and severe vs. no glaucoma) and hip fracture, after adjusting for age, sex, race and ethnicity, and Charlson Comorbidity Index score. A subgroup analysis was performed only in individuals with glaucoma to examine the odds of hip fracture for those with moderate and severe glaucoma compared to those with mild glaucoma.
Main outcome measures: The variations in the odds of hip fractures for patients with and without glaucoma and for patients with moderate and severe glaucoma compared to those with mild glaucoma.
Results: Of the 2 717 346 beneficiaries in the study population, 220 662 (8.1%) had glaucoma. In multivariable regression analysis, those with mild (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.78-0.88) and moderate glaucoma (OR: 0.88; 95% CI: 0.84-0.92) had reduced odds of hip fracture compared with those with no glaucoma. There was no statistically significant association between severe vs. no glaucoma and hip fracture (OR: 0.96; 95% CI: 0.91-1.02). Among individuals with glaucoma, the odds of hip fracture were higher for those with severe glaucoma (OR: 1.17; 95% CI: 1.08-1.27), compared with those with mild glaucoma.
Conclusions: In the CA Medicare population, the presence of glaucoma was associated with decreased likelihood of hip fracture. However, in those with glaucoma, increased glaucoma severity was associated with an increased likelihood of hip fracture. Potential mediating mechanisms requiring further study include fear of falls and physical inactivity in patients with glaucoma.
Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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