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台湾地区髋部骨折老年患者髋关节手术后肌少症及其相关结局的高患病率。

The high prevalence of sarcopenia and its associated outcomes following hip surgery in Taiwanese geriatric patients with a hip fracture.

机构信息

Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

Department of Orthopedic Surgery, Puli Christian Hospital, Nantou, Taiwan.

出版信息

J Formos Med Assoc. 2020 Dec;119(12):1807-1816. doi: 10.1016/j.jfma.2020.02.004. Epub 2020 Feb 25.

Abstract

BACKGROUND

Sarcopenia, which is a common risk factor for falls and fractures, affects the functional outcome and mortality in geriatric populations. However, the prevalence of sarcopenia among geriatric Taiwanese patients with a hip fracture is unknown, nor is the effect of sarcopenia on the outcome of hip surgery.

METHODS

From December 2017 to February 2019, geriatric patients who underwent surgery for a hip fracture were prospectively enrolled. Basic demographic data, responses to questionnaires for dementia screening and quality of life (QoL) and daily living activities (ADL) before the injury were analyzed to identify any association with sarcopenia. The QoL and ADL were monitored at six months after the operation to determine the difference between hip fracture patients with or without sarcopenia.

RESULTS

Of 139 hip fracture patients, 70 (50.36%) were diagnosed with sarcopenia. Accounting for all confounding factors in the multivariate logistic regression, lower body mass index (BMI), male gender and a weaker handgrip are the risk factors that are most strongly associated with a diagnosis of sarcopenia in geriatric patients with a hip fracture. Hip fracture patients with sarcopenia also have poor ADL and a lower QoL than patients without sarcopenia before the injury and six months after the operation.

CONCLUSION

A high prevalence of sarcopenia among geriatric hip fracture patients is associated with a poor mid-term outcome following hip surgery. Clinicians must recognize the risk of sarcopenia, especially for male hip fracture patients with a lower BMI and a weaker handgrip.

摘要

背景

肌少症是跌倒和骨折的常见危险因素,影响老年人群的功能结局和死亡率。然而,尚不清楚老年台湾髋部骨折患者中肌少症的患病率,也不清楚肌少症对髋部手术结局的影响。

方法

从 2017 年 12 月至 2019 年 2 月,前瞻性纳入接受髋部骨折手术的老年患者。分析基本人口统计学数据、痴呆筛查和生活质量(QoL)及受伤前日常生活活动(ADL)问卷的回答,以确定与肌少症的任何关联。术后 6 个月监测 QoL 和 ADL,以确定有无肌少症的髋部骨折患者之间的差异。

结果

在 139 例髋部骨折患者中,70 例(50.36%)被诊断为肌少症。在多变量逻辑回归中考虑所有混杂因素后,较低的体重指数(BMI)、男性和较弱的握力是与老年髋部骨折患者肌少症诊断最密切相关的危险因素。肌少症的髋部骨折患者在受伤前和术后 6 个月的 ADL 较差,QoL 也低于无肌少症的患者。

结论

老年髋部骨折患者中肌少症的高患病率与髋部手术后中期结局不良相关。临床医生必须认识到肌少症的风险,特别是对于 BMI 较低和握力较弱的男性髋部骨折患者。

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