From the Osteoporosis Research Center, Division of Physical Medicine and Rehabilitation, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Torino, Italy.
Am J Phys Med Rehabil. 2018 Jun;97(6):401-406. doi: 10.1097/PHM.0000000000000875.
The aim of the study was to assess the capability of different definitions of low appendicular lean mass (aLM) to predict the short-term functional recovery in men with hip fracture.
We investigated 80 of 95 men with hip fracture admitted consecutively to a rehabilitation hospital. Body composition was assessed by dual-energy x-ray absorptiometry. Functional recovery after inpatient rehabilitation was evaluated using Barthel Index scores.
The patients with aLM above the cutoff value of 19.75 kg indicated by the Foundation for the National Institutes of Health (FNIH) had significantly higher Barthel Index scores than those with aLM below the cutoff value (P = 0.002). Patients' categorization according to the same threshold (aLM = 19.75 kg) was significantly associated with a Barthel Index score of 85 or higher after adjustment for age, cognitive impairment, hip fracture type, co-morbidities, and medications (odds ratio = 7.17, 95% confidence interval = 1.43-35.94, P = 0.017). Conversely, patients' categorization according to neither Baumgartner's cutoff value (7.26 kg/m(2)) for aLM/height(2) nor Foundation for the National Institutes of Health cutoff value (0.789) for aLM divided by body mass index was significantly associated with the Barthel Index scores.
Categorization according to the Foundation for the National Institutes of Health threshold for aLM, but not to the Foundation for the National Institutes of Health threshold for aLM/body mass index or Baumgartner's threshold for aLM/height, was associated with the short-term recovery in activities of daily living after a hip fracture in men.
本研究旨在评估不同的低四肢瘦体重(aLM)定义预测髋部骨折男性短期功能恢复的能力。
我们调查了连续入住康复医院的 95 名髋部骨折男性中的 80 名。通过双能 X 射线吸收法评估身体成分。通过 Barthel 指数评分评估住院康复后的功能恢复。
四肢瘦体重高于 NIH 基金会(FNIH)确定的截断值(19.75kg)的患者的 Barthel 指数评分明显高于四肢瘦体重低于截断值的患者(P=0.002)。根据相同的阈值(aLM=19.75kg)对患者进行分类,在调整年龄、认知障碍、髋部骨折类型、合并症和药物治疗后,与 Barthel 指数评分≥85 显著相关(优势比=7.17,95%置信区间=1.43-35.94,P=0.017)。相反,根据 Baumgartner 的四肢瘦体重/身高(2)截断值(7.26kg/m2)或 NIH 基金会的四肢瘦体重/体重指数截断值(0.789)对患者进行分类与 Barthel 指数评分无显著相关性。
根据 NIH 基金会的四肢瘦体重阈值进行分类,但不是根据 NIH 基金会的四肢瘦体重/体重指数或 Baumgartner 的四肢瘦体重/身高的阈值进行分类,与髋部骨折男性短期日常生活活动恢复相关。