相位角作为脆性骨质疏松性骨折患者身体功能的预测指标

Yusuke Ito, Y. Yoshimura, F. Nagano, A. Matsumoto, Shin Nomura
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摘要

【摘要】目的:本研究旨在探讨骨质疏松性脆性骨折患者的相位角是否与出院时和出院目的地的身体功能有关。方法:本回顾性队列研究纳入了住在康复病房的脆性骨质疏松性骨折患者。采用体成分计和生物电阻抗分析计算相位角。出院时的主要终点是功能独立测量运动(FIM-motor)评分,次要终点是出院回家。采用多变量分析确定相位角与出院和出院回家时FIM-motor评分之间的关系。结果:纳入127例患者(女性108例,年龄81.2±9.7岁)。入院时的中位相位角男性为4.1°,女性为3.6°。出院时FIM-motor评分中位数为83,其中92例(72.4%)出院回家,35例(27.6%)出院到其他地方。校正混杂因素的多元回归分析显示,放电时相位角与FIM-motor评分之间存在显著的独立相关性(β=0.262, P=0.019)。然而,相位角与放电目的地之间没有显著相关性(优势比,1.350;95%置信区间:0.680-2.670,P=0.391)。结论:相位角与脆性骨质疏松性骨折患者出院时的身体功能独立相关。对于入院时相角降低的患者,应实施多学科治疗,包括运动、营养、口腔健康和药物治疗,以最大限度地改善身体功能。
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Phase Angle as a Prognostic Predictor for Physical Function in Fragile Osteoporotic Fracture Patients
ABSTRACT Objectives: This study aimed to determine whether the phase angle is associated with physical function at discharge and discharge destination in patients with osteoporotic fragile fractures. Methods: This retrospective cohort study included patients with fragile osteoporotic fractures who were admitted to a convalescent rehabilitation ward. The phase angle was calculated using a body composition meter and bioelectrical impedance analysis. The primary outcome was the Functional Independence Measure motor (FIM-motor) score at discharge, and the secondary outcome was discharge to home. Multivariate analysis was used to determine the association between phase angle and FIM-motor scores at discharge and discharge to home. Results: The study included 127 patients (108 women, age 81.2 ± 9.7 years). The median phase angle on admission was 4.1° for men and 3.6° for women. The median FIM-motor score at discharge was 83, with 92 (72.4%) patients discharged home and 35 (27.6%) discharged to a destination other than home. Multiple regression analysis adjusted for confounders revealed a significant independent association between the phase angle and FIM-motor score at discharge (β=0.262, P=0.019). However, no significant association was found between phase angle and discharge destination (odds ratio, 1.350; 95% confidence interval: 0.680–2.670, P=0.391). Conclusions: Phase angle was independently associated with physical function at discharge in patients with fragile osteoporotic fractures. For patients with a reduced phase angle on admission, a multidisciplinary approach, including exercise, nutrition, oral health, and medication, should be implemented to maximize improvement in physical function.
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