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Introduction. Hip fracture (HF) are the most serious complication of osteoporosis and a serious public health problem, causing significant economic damage. They are characterized by a high level of mortality as an inpatient and outpatient stages. Rate of severe outcome depends on the organization of medical care of these patients. Goal. To evaluate the frequency of lethality in patients undergoing HF. Subjects and methods. A longitudinal observational cohort study among residents of the city of Yaroslavl at the age of 50 years and older who received HF for the period from 01.09.2010 to 31.08.2011 years, with follow-up of 24 months (up visits 3, 6, 12 and 24 month after the date of fracture). The analysis of lethality was performed by using of life tables and the analysis of the «censored» cases. Results. Overall lethality in hospital was 9.66%, in 3 months - 21,75%, after 6 months - 26,46%, 12 months -29,82%, 24 months - 34,53%. The next characteristics of the lethality were analyzed at every stage of observation: a density of probability, function of the intensity and immediate risk of the death, the expected median of lifetime. Conclusion. The analysis allowed to obtain the most accurate and complete data on the lethality in patients with HF and to evaluate several additional features of this indicator.

Introduction. The incidence of fractures of the proximal femur (FPF), fractures of the forearm and humerus was studied in two cities of the Russian Federation. This index was used to create the Russian model FRAX and to assess the present and future burden of fractures. Objective. So far, little is known about the epidemiology of fractures in Russia. The aim of the study was to determine the incidence of major fractures to create a Russian model of FRAX and evaluate the present and future burden of fractures. Materials and methods. In well-defined populations of two Russian cities, we had determined a number FPF and forearm fractures of the humerus for 2-2-year period. Data were combined and the resulting incidence used to calculate FRAX model for the Russian Federation and to calculate the projected number of fractures in the Russian Federation in 2010 and 2025. Results. A total of 6012 fractures were identified. Among all FPF, 27% of Pervouralsk and 1.8% in Yaroslavl were not registered on the official data of medical institutions. The incidence of fractures increased with age and was higher in women than in men. The probability of experiencing a FPF in later life at the age of 50 years was 4% of men and 7% of women. Total number FPF in 2010 was 112 thousand cases and it is expected to rise by 2025 to 159 thousand a year. The estimated number of major osteoporotic fractures will increase from 590 thousand to 730 thousand cases for the same period. Conclusions. Osteoporotic fractures are a serious health problem for Russia. It is necessary to take urgent measures to improve emergency care at FPF and long-term care for this and other osteoporotic fractures.

Fractures of the proximal femur (FPF) significantly affect the increase of mortality and disability in men. According to the data of the epidemiological studies in Russian Federation the incidence FPF at the age of 65 years is higher in men than in women, which is different from those obtained in most other countries. Objective: To assess the risk factors for fracture and to estimate the risk of fracture using the FRAX in order to calculate the absolute risk of fracture in men with occurred FPF. Materials and Methods: We performed a cross-sectional continuous epidemiological study. The study group included 128 men 40-69 years old with FPF, the comparison group consisted of 108 patients with FPF 70 years of age or older. The patients filled out questionnaires to assess the risk factors for fracture. Alcohol consumption was estimated based on the results of tests «CAGE» and «Audit». In order to identify vertebral fractures we performed radiography of thoracic and lumbar spine with morphometric studies. We measured the levels of testosterone and 17-estradiol electrochemiluminescence immunoassay «ECLIA» (Elecsys 2010). FRAX (www.shef.ac.uk\FRAX) was applied to estimate the absolute risk of fracture; the results were interpreted according to the schedule thresholds depending on the patient’s age (www.osteoporoz.ru). Statistical analysis was performed using STATISTICA v.10.0 software. Results: The patients in the study group had more prior fractures (p

Актуальность. В ходе проведенных эпидемиологических исследований по оценке инцидентности ППОБ было получено, что в возрасте 50-69 лет данный показатель выше у мужчин по сравнению с женщинами, в то время как после 70 лет он значительно преобладает у женщин. В связи с этим было выполнено исследование для оценки факторов, которые могли стать причиной выявленной закономерности. Цель. Создание диагностической модели прогнозирования вероятности получения ППОБ у мужчин в возрасте до 70 лет. Материал и методы. Было проведено сплошное исследование по типу случай-контроль среди мужчин г. Ярославля в возрасте 40-69 лет, получивших ППОБ с 01.09.2010 по 01.02.2012 гг. (n=128). Контрольную группу составили мужчины того же возраста без переломов, прошедших диспансеризацию и отнесенных к 1-й группе здоровья (n=50). Изученные в группах исследования факторы риска остеопороза, сопутствующие заболевания, лабораторные показатели (уровень свободного тестостерона, 17-эстрадиола, пролактина, паратиреоидного гормона, тиреотропного гормона, 25(ОН)-витамина D), результаты оценки МПК по DXA были последовательно включены в модели биноминальной многофакторной логистической регрессии. После получения уравнения логистической регрессии выполнена процедура ROC-анализа с построением соответствующих ROC-кривых. В результате получены несколько вариантов моделей, имевших достаточную статистическую значимость для прогнозирования развития ППОБ у пациентов в возрасте 40-69 лет. С целью выявления наиболее прогностически мощной комбинации учетных переменных проведена процедура сравнения площади под кривой (AUC) в каждой из созданных моделей. Статистический анализ выполнен с помощью прикладных программ STATISTICA 12 и MedCalc Statistical Software version 15.8. Результаты. Наибольшую стабильность и приемлемые характеристики имела модель, включившая в себя сочетание таких факторов, как нарушение зрения, артериальная гипертензия, уровень 25(ОН)-витамина D и курение, p

Osteoporosis (OP) is one of the most common diseases and is characterized by serious clinical manifestations such as low-energy bone fractures that cause severe social consequences. In this connection, OP is now receiving much attention worldwide. In Yaroslavl, the Department of Therapy (Head, Professor N.I. Korshunov, MD), Institute of Postgraduate Education, Yaroslavl State Medical University (Chancellor, Prof. A.V. Pavlov, MD), has been intensively conducting researches into different aspects of OP for more than 20 years. The main areas of the investigations performed are the issues of the epidemiology and outcomes of osteoporotic fractures, the relationship of OP to different diseases (rheumatoid arthritis, cardiovascular diseases), as well as the specific features of the development of OP in fertile men and women and the problem of calcium and vitamin D deficiency in pregnant women.