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相位角作为预测髋部骨折手术后住院康复患者功能结局的指标。

Phase angle as a predictor of functional outcomes in patients undergoing in-hospital rehabilitation after hip fracture surgery.

机构信息

Department of Rehabilitation Medicine, Gyeongsang National University Changwo Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea.

Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea; Institute on Aging, Seoul National University.

出版信息

Arch Gerontol Geriatr. 2020 Jul-Aug;89:104060. doi: 10.1016/j.archger.2020.104060. Epub 2020 Apr 9.

Abstract

OBJECTIVES

To evaluate the association between the phase angle and functional outcomes in patients after in-hospital postoperative rehabilitation for fragility hip fracture.

METHODS

A prospective observational study was conducted in 68 patients over 65 years of age who had undergone a two-week postoperative rehabilitation for hip fracture. Phase angle of the non-fractured limb was used to reduce the error caused by postoperative edema. Participants were divided into groups according to phase angle terciles. Multivariable linear regression models adjusted for relevant factors known to affect functional outcomes after hip fracture were performed to identify the association between phase angle of the non-fractured limb and functional outcomes at discharge as evaluated the Functional Ambulation Category and Berg Balance Scale.

RESULTS

The mean age of this study population was 81.9 ± 6.2 years and the average phase angle of the non-fractured limb was 3.6 ± 1.3°. The lowest tercile of phase angle (<3.0°) was independently associated with worse functional outcomes as measured by the Functional Ambulation Category and Berg Balance Scale at discharge (adjusted coefficient [β] = -0.287, P = 0.004; β = -0.172, P = 0.049, respectively) after adjusting for relevant covariates.

CONCLUSIONS

Low phase angle of the non-fractured limb was independently associated with worse functional outcomes at rehabilitation discharge in patients who undergoing hip fracture surgery. Phase angle may reflect both the pre-fracture body composition and functional status. It is a useful indicator for functional outcomes after postoperative rehabilitation for fragility hip fracture.

摘要

目的

评估髋部脆性骨折患者术后住院康复期间相位角与功能结局的相关性。

方法

对 68 名 65 岁以上接受髋部骨折术后 2 周康复治疗的患者进行前瞻性观察研究。使用未骨折肢体的相位角来减少术后水肿引起的误差。根据相位角三分位数将参与者分为不同组。采用多变量线性回归模型,调整已知影响髋部骨折后功能结局的相关因素,以确定未骨折肢体相位角与功能结局(采用功能性步行分类和伯格平衡量表评估)在出院时的相关性。

结果

该研究人群的平均年龄为 81.9±6.2 岁,未骨折肢体的平均相位角为 3.6±1.3°。相位角最低三分位数(<3.0°)与出院时功能性步行分类和伯格平衡量表评估的功能结局较差独立相关(调整后的系数[β]分别为-0.287,P=0.004;β=-0.172,P=0.049),校正了相关协变量。

结论

髋部骨折手术后,未骨折肢体的相位角较低与康复出院时的功能结局较差独立相关。相位角可能反映了骨折前的身体成分和功能状态。它是术后脆性髋部骨折康复后功能结局的一个有用指标。

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