老年人低能量骨盆骨折后的临床虚弱和短期疗效:2016-2018年全国住院病人样本分析。

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Bone Pub Date : 2024-08-06 DOI:10.1016/j.bone.2024.117225
Yu-Cheng Lo , Chih-Hui Chen , Chiu Yu Shih , Omar Toma
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引用次数: 0

摘要

背景:骨盆骨折对骨质疏松的老年人来说可能会危及生命。虚弱与骨折结果有关,但其对骨盆骨折恢复的影响仍未得到探讨。本研究旨在调查因低能量骨盆骨折住院的老年人的虚弱程度与短期疗效之间的关系:研究回顾了 2005 年至 2018 年全国住院患者样本(NIS)的数据。纳入标准为因低能骨盆骨折住院的患者年龄≥60岁。采用11因子改良虚弱指数(mFI-11)将患者分为虚弱组和非虚弱组。通过单变量和多变量回归分析确定虚弱与院内预后之间的关系:共纳入 24,688 名骨盆骨折患者。患者平均年龄为(80.6 ± 0.1)岁,35%的患者被归类为体弱者。经调整后,体弱与不利出院显著相关(调整后的几率比 [aOR] = 1.07,95% 置信区间 [CI]:1.00-1.15,P<0.05):1.00-1.15,p = 0.038)、住院时间延长(aOR = 1.51,95 % 置信区间[CI]:1.41-1.62,p 结论:≥60 岁的患者中,体弱者的比例最高:与非虚弱患者相比,经 mFI-11 评估为虚弱且发生低能量骨盆骨折的≥60 岁患者发生院内不良预后的风险更高。还需要进行更多的研究来揭示临床虚弱对出院后长期功能预后和生活质量的影响。
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Clinical frailty and short-term outcomes after low-energy pelvic fracture in the geriatric population: Nationwide inpatient sample 2016–2018 analysis

Background

Pelvic fractures can be life-threatening for elderly individuals with diminished bone strength. Frailty is associated with fracture outcomes, but its impact on pelvic fracture recovery remains unexplored. The aim of this study was to investigate the association between frailty and short-term outcomes in older adults hospitalized for low-energy pelvic fractures.

Methods

Data from the Nationwide Inpatient Sample (NIS) covering the years 2005 to 2018 were reviewed. Inclusion criteria were age ≥ 60 years admitted for a low-energy pelvic fracture. Patients were categorized into frail and non-frail groups using the 11-factor modified Frailty Index (mFI-11). Association between frailty and in-hospital outcomes were determined by univariate and multivariable regression analyses.

Results

A total of 24,688 patients with pelvic fractures were included. The mean patient age was 80.6 ± 0.1 years, and 35 % were classified as frail. After adjustments, frailty was significantly associated with unfavorable discharge (adjusted odds ratio [aOR] = 1.07, 95 % confidence interval [CI]: 1.00–1.15, p = 0.038), prolonged hospitalization (aOR = 1.51, 95 % CI: 1.41–1.62, p < 0.001), complications (aOR = 1.42, 95 % CI:1.34–1.50, p < 0.001), and acute kidney injury (aOR = 1.68, 95 % CI: 1.56–1.82, p < 0.001). Stratified analyses based on age and fracture type showed frailty was consistently associated with adverse outcomes.

Conclusions

Persons ≥60 years old with mFI-11 assessed frailty and a low-energy pelvic fracture are at higher risk of adverse in-hospital outcomes than non-frail patients. Additional research is needed to disclose the prognostic impact of clinical frailty on long-term functional outcomes and quality of life after discharge.

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来源期刊
Bone
Bone 医学-内分泌学与代谢
CiteScore
8.90
自引率
4.90%
发文量
264
审稿时长
30 days
期刊介绍: BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.
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