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手握力与髋部骨折后早期死亡率。

Hand grip strength and early mortality after hip fracture.

机构信息

Instituto Mexicano del Seguro Social, México, Mexico.

Hospital Aranda de la Parra, León, México.

出版信息

Arch Osteoporos. 2020 Nov 21;15(1):185. doi: 10.1007/s11657-020-00750-3.

Abstract

UNLABELLED

This research describes the risk of death in elderly after hip fracture according to their strength, measured by hand grip. The result is that the weaker the patient, the greater the risk of death after hip fracture, highlighting the need to assess the force in those patients. For the coming years, most of hip fractures will occur in developing countries. It has been described that low muscular strength, measured by grip strength, increases the risk of mortality in those with hip fracture, in both high-and low- income countries. The objective of this study was to determine the mortality among patients with hip fracture and lower hand grip strength (HGS).

MATERIAL AND METHODS

We conducted a cohort and longitudinal study at Hip and Pelvic Surgery Department of a tertiary hospital, in Monterrey, Mexico. The study included patients aged over of 69, admitted for hip fracture surgery from February 1st 2013 to July 31st 2014. HGS measurement was performed by a trained physician at arrival to emergency department prior to surgery; clinimetric variables were asked, and a complete medical history was included.

RESULTS

A total of 670 patients were included in the study and grouped in different tertiles according to hand grip strength. During follow-up, there were 112 deaths (17.4%), 61 (27.5%) in tertile 1, 37 (17.1%) in tertile 2, and 14 (6.8%) in tertile 3, p < 0.001. The association remained significant after adjusting for confounding variables. Less than 5% of patients discharged from hospital were identified with osteoporosis.

CONCLUSION

Lower hand grip strength in patients with a hip fracture is associated with high mortality after hip fracture.

摘要

目的

本研究根据手握力(通过手握力测量)描述了老年髋部骨折患者的死亡风险。结果表明,患者握力越弱,髋部骨折后死亡的风险越大,这突出了评估此类患者握力的必要性。在未来几年,大多数髋部骨折将发生在发展中国家。已有研究表明,在高收入和低收入国家,通过手握力测量的低肌肉力量都会增加髋部骨折患者的死亡率。本研究的目的是确定髋部骨折且手握力较低(HGS)患者的死亡率。

材料和方法

我们在墨西哥蒙特雷的一家三级医院的髋关节和骨盆外科进行了队列和纵向研究。该研究纳入了 2013 年 2 月 1 日至 2014 年 7 月 31 日因髋部骨折手术入院的年龄在 69 岁以上的患者。在手术前到达急诊部时,由经过培训的医生进行 HGS 测量;询问临床测量变量,并纳入完整的病史。

结果

共有 670 例患者纳入本研究,并根据手握力分为不同的三分位组。在随访期间,共有 112 例患者死亡(17.4%),第 1 三分位组 61 例(27.5%),第 2 三分位组 37 例(17.1%),第 3 三分位组 14 例(6.8%),p<0.001。调整混杂变量后,这种相关性仍然显著。出院患者中只有不到 5%被诊断为骨质疏松症。

结论

髋部骨折患者手握力较低与髋部骨折后死亡率较高相关。

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