國家衛生研究院 NHRI:Item 3990099045/15675
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/15675


    Title: Association between long‑term exposure to air pollution and the rate of mortality after hip fracture surgery in patients over 60 years old: A nationwide cohort study in Taiwan
    Authors: Chuang, SH;Kuo, YJ;Huang, SW;Zhang, HW;Peng, HC;Chen, YP
    Contributors: Institute of Population Health Sciences
    Abstract: BACKGROUND: To enhance postoperative patient survival, particularly in the elderly, understanding the predictors of mortality following hip fracture becomes paramount. Air pollution, a prominent global environmental issue, has been linked to heightened morbidity and mortality across a spectrum of diseases. Nevertheless, the precise impact of air pollution on hip fracture outcomes remains elusive. OBJECTIVE: This retrospective study was conducted to comprehensively investigate the profound influence of a decade-long exposure to twelve diverse air pollutants on the risk of post-hip-fracture mortality among elderly Taiwanese patients (aged > 60 years). We hypothesized that enduring long-term exposure to air pollution would significantly elevate the one-year mortality rate following hip fracture surgery. METHODS: From Taiwan's National Health Insurance Research Database, we obtained the data of patients who underwent hip fracture surgery between July 1, 2003, and December 31, 2013. Employing patients' insurance registration data, we estimated their cumulative exposure levels to sulfur dioxide (SO2), carbon dioxide (CO2), carbon monoxide (CO), ozone (O3), particulate matter having a size of <10 μm (PM10), particulate matter having a size of <2.5 μm (PM2.5), nitrogen oxides (NOX), nitrogen monoxide (NO), nitrogen dioxide (NO2), total hydrocarbons (THC), nonmethane hydrocarbons (NMHC), and methane (CH4). We quantified the dose-response relationship between these air pollutants and the risk of mortality by calculating hazard ratios (HRs) associated with a 1-standard-deviation (SD) increase in exposure levels over a decade. RESULTS: Long-term exposure to SO2, CO, PM10, PM2.5, NOX, NO, NO2, THC, NMHC, and CH4 demonstrated significant associations with heightened all-cause mortality risk within one-year post-hip-fracture surgery among the elderly. For older adults, each 1-SD increment in the average exposure levels of SO2, CO, PM10, PM2.5, NOX, NO, NO2, THC, NMHC, and CH4 corresponded to a substantial escalation in mortality risk, with increments of 14%, 49%, 18%, 12%, 41%, 33%, 38%, 20%, 9%, and 26%, respectively. We further noted a 35% reduction in the HR for ozone exposure suggesting a potential protective effect, along with a trend of potentially protective effects of CO2. CONCLUSIONS: This comprehensive nationwide retrospective study, grounded in a population-based approach, demonstrated that long-term exposure to specific air pollutants significantly increased the risk of all-cause mortality within one year after hip fracture surgery in older Taiwanese adults. A reduction in the levels of SO2, CO, PM10, PM2.5, NOX, NO, NO2, THC, NMHC, and CH4 may reduce the risk of mortality after hip fracture surgery. This study provides robust evidence and highlights the substantial impact of air pollution on the outcomes of hip fracture.
    Date: 2024-03-18
    Relation: JMIR Public Health and Surveillance. 2024 Mar 18:10:Article number e46591.
    Link to: http://dx.doi.org/10.2196/46591
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2369-2960&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:001190543200002
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85188201288
    Appears in Collections:[Others] Periodical Articles

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