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骨质疏松性椎体压缩骨折患者中衰弱的患病率及其与骨折数量的关联

Prevalence of Frailty in Patients with Osteoporotic Vertebral Compression Fracture and Its Association with Numbers of Fractures.

作者信息

Kim Ho Joong, Park Saejong, Park Soo Hyun, Park Jiwon, Chang Bong Soon, Lee Choon Ki, Yeom Jin S

机构信息

Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Division of Sports Science, Korea Institute of Sports Science, Seoul, Korea.

出版信息

Yonsei Med J. 2018 Mar;59(2):317-324. doi: 10.3349/ymj.2018.59.2.317.

Abstract

PURPOSE

To assess the association between frailty and osteoporotic vertebral compression fracture (OVCF) and to evaluate the relationship between numbers of OVCFs and frailty.

MATERIALS AND METHODS

We enrolled 760 subjects, including 59 patients (with OVCF) and 701 controls (without OVCF). Successful matching provided 56 patient-control pairs. We analyzed principal clinical and demographic information, which included sex, age, height, weight, body mass index (BMI), variable frailty phenotypes, and Oswestry Disability Index (ODI) and EuroQol 5-dimension questionnaire (EQ-5D) scores. The association between frailty and OVCF was ascertained. In addition, the degrees of disability and quality of life attributable to frailty were determined.

RESULTS

The prevalence of frailty was significantly higher in the OVCF group than in the control group (p<0.001). Most of the frailty phenotypes, such as exhaustion, physical inactivity, slowness, and handgrip strength, were also significantly observed in the OVCF group. Within the OVCF group, the participants with frailty had significantly higher disability and lower quality of life than those in a robust state (p<0.001 for ODI and EQ-5D). In addition, the multivariate logistic regression analysis demonstrated that the patients with low BMI [odds ratio (OR)=0.704; 95% confidence interval (CI), 0.543-0.913] and ≥3 fractures (OR=9.213; 95% CI, 1.529-55.501) within the OVCF group were associated with higher odds of frailty.

CONCLUSION

The present study showed significant relationships between frailty and OVCF, severity of symptoms, and disability induced by OVCF. Furthermore, frailty could be a causal and/or resulting factor of OVCFs.

摘要

目的

评估衰弱与骨质疏松性椎体压缩骨折(OVCF)之间的关联,并评估OVCF数量与衰弱之间的关系。

材料与方法

我们纳入了760名受试者,包括59例(患有OVCF)患者和701名对照者(无OVCF)。成功匹配后得到56对患者-对照。我们分析了主要的临床和人口统计学信息,包括性别、年龄、身高、体重、体重指数(BMI)、不同的衰弱表型,以及Oswestry功能障碍指数(ODI)和欧洲五维健康量表(EQ-5D)评分。确定了衰弱与OVCF之间的关联。此外,还确定了由衰弱导致的残疾程度和生活质量。

结果

OVCF组的衰弱患病率显著高于对照组(p<0.001)。在OVCF组中也显著观察到了大多数衰弱表型,如疲惫、身体活动不足、行动迟缓以及握力下降。在OVCF组内,衰弱的参与者比身体强壮的参与者有显著更高的残疾程度和更低的生活质量(ODI和EQ-5D的p<0.001)。此外,多因素逻辑回归分析表明,OVCF组中BMI较低的患者[比值比(OR)=0.704;95%置信区间(CI),0.543 - 0.913]和有≥3处骨折的患者(OR=9.213;95%CI,1.529 - 55.501)发生衰弱的几率更高。

结论

本研究表明衰弱与OVCF、症状严重程度以及OVCF所致残疾之间存在显著关系。此外,衰弱可能是OVCF的一个因果和/或结果因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3b9/5823836/c9dcea868046/ymj-59-317-g001.jpg

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