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Multimorbidity patterns among fragility fracture patients aged 50 + years in China and the US
Qi Meng1,2, Yi Wang2, Linghua Yang2
1Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China.
Insights
Hyperlipidemia is a common comorbidity in fragility fracture patients in China and the US. US fracture patients exhibit complex comorbidity networks similar to those without fractures.
Area of Science:
- Gerontology
- Epidemiology
- Public Health
Background:
- Fragility fractures disproportionately affect older adults, increasing the risk of multimorbidity.
- Understanding comorbidity patterns in fragility fracture patients is crucial for effective healthcare management.
- Cross-cultural comparisons of multimorbidity in fragility fractures are limited.
Purpose of the Study:
- To investigate and compare multimorbidity patterns in fragility fracture patients aged 50 years and older in China and the United States.
- To analyze the complexity of comorbidity networks in these patient populations.
Main Methods:
- Utilized inpatient electronic medical records from China (2018-2023) and the National Health and Nutrition Examination Survey (NHANES) from the US (1999-2020).
- Identified fragility fracture patients aged ≥50 years and matched US fracture patients with non-fracture controls.
- Analyzed 28 chronic diseases in China and 19 in the US, using average degree to assess comorbidity network complexity.
Main Results:
- Included 2086 Chinese and 1227 US fracture patients; 73% were female.
- Hyperlipidemia was the most prevalent comorbidity in both countries, except for US females (osteoporosis).
- US fracture patients showed comorbidity network complexity similar to non-fracture individuals.
Conclusions:
- Hyperlipidemia is a primary comorbidity in fragility fracture patients across China and the US, with notable exceptions in US females.
- Fragility fracture patients in the US share similar complex comorbidity networks with the general population.
- These findings highlight the importance of managing hyperlipidemia and understanding comorbidity profiles in older adults with fragility fractures.
Abstract:
We examined the multimorbidity patterns among fragility fracture patients in China and the US. Except for female fracture patients in US, hyperlipidemia was the most prevalent comorbidity among fracture patients in China and the US. US fracture patients demonstrated a similar complex comorbidity network to non-fracture individuals.
Purpose:
To examine the multimorbidity patterns among fragility fracture patients aged 50 + years in China and the US.
Methods:
We extracted inpatient electronic medical records at the First Affiliated Hospital of Jinzhou Medical University, China between 2018 and 2023, and data from the National Health and Nutrition Examination Survey (NHANES) 1999-2020. Fragility fracture patients aged ≥ 50 years were identified. In the NHANES, we matched each fracture patient with a non-fracture individual by age (< 1 year), sex and survey cycle. We identified 28 and 19 chronic diseases in the Chinese and NHANES databases, respectively. Average degree was used to characterize the complexity of comorbidity network.
Results:
A total of 2086 Chinese fracture patients, 1227 US fracture and 1227 non-fracture individuals were included (73% females). The most prevalent comorbidity among Chinese fracture patients was hyperlipidemia (male: 63.3%; female: 65.2%). In US fracture patients, the most prevalent comorbidity was hyperlipidemia (67.3%) in males and osteoporosis (78.3%) in females. The most prevalent disease pair was osteoporosis and hyperlipidemia among US fracture patients (male: 40.8%; female: 61.4%), and hypertension and hyperlipidemia among Chinese fracture patients (male: 26.6%; female: 29.4%). The multimorbidity pattern of US fracture patients was similar to that of non-fracture individuals (average degree: 7.82 vs. 7.59 in males; 7.94 vs. 7.44 in females).
Conclusion:
Except among female fracture patients in the US, hyperlipidemia was the most prevalent comorbidity among Chinese and US fragility fracture patients. US fracture patients demonstrated a similar complex comorbidity network to non-fracture individuals.
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