利用相位角预测椎体压缩性骨折老年妇女的行走独立性:使用倾向评分的初步研究。

Progress in rehabilitation medicine Pub Date : 2024-01-30 eCollection Date: 2024-01-01 DOI:10.2490/prm.20240004
Megumi Kurita, Takaaki Fujita, Ryuichi Kasahara, Yuichi Yamamoto, Yoko Ohira, Koji Otsuki, Shinichiro Morishita
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摘要

研究目的本研究旨在明确相位角是否可以预测患有椎体压缩性骨折(VCF)的老年妇女的行走独立性,并确定一个临床可用的临界值:我们回顾性地评估了患有椎体压缩性骨折的老年妇女(59 人,中位年龄 83.0 岁)的数据。我们采用倾向评分匹配和逻辑回归的方法来研究入院时的相位角与出院时独立行走之间的关系。根据接收者操作特征曲线计算了入院时相位角预测步行独立性的临界值:31名患者(52.5%)出院时可以独立行走。根据倾向得分从独立组和非独立组中抽取了 30 名患者。倾向得分匹配后,两组患者在年龄、病史、膝关节伸展力量、骨骼肌质量指数、迷你营养评估-简表评分或修订版长谷川痴呆量表评分方面无显著差异。然而,独立组的相位角明显高于非独立组(结论:这项研究表明,相位角可以预测患有VCF的老年女性的行走独立性。本研究中计算出的女性分界值可作为行走独立性的简单而客观的预测指标。
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Prediction of Walking Independence in Older Women with Vertebral Compression Fracture Using Phase Angle: A Preliminary Study Using Propensity Score.

Objectives: This study aimed to clarify whether phase angle can be a predictor of walking independence in older women with vertebral compression fractures (VCFs) and to determine a clinically usable cutoff value.

Methods: We retrospectively assessed data of older women (n=59; median age, 83.0 years) with VCFs. Propensity score-matching and logistic regression were performed to examine the association between phase angle at admission and walking independence at discharge. The cutoff value for the phase angle at admission for predicting walking independence was calculated based on the receiver operating characteristic curve.

Results: Thirty-one patients (52.5%) could walk independently at discharge. Thirty patients were extracted from the independent and non-independent groups according to the propensity score. After propensity score matching, there was no significant difference between the groups for age, medical history, knee extension strength, skeletal muscle mass index, mini nutritional assessment-short form score, or revised Hasegawa's dementia scale score. However, the phase angle of the independent group was significantly higher than that of the non-independent group (P<0.05). Logistic regression revealed that phase angle at admission was significantly associated with walking independence at discharge (odds ratio, 12.2; 95% confidence interval, 2.1-72.0; P<0.01). The area under the receiver operating characteristic curve was 0.868, and the calculated phase angle cutoff value was 3.55°.

Conclusions: This study revealed that the phase angle can predict walking independence in older women with VCFs. The cutoff values for women calculated in this study can be used as a simple and objective predictive index of walking independence.

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