Servicio de Medicina Física y Rehabilitación, Hospital Vall d'Hebron, Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España.
Universidad Autónoma de Barcelona, Barcelona, España; Servicio de Farmacología Clínica, Hospital Vall d'Hebron, Barcelona, España.
Med Clin (Barc). 2022 Feb 11;158(3):111-117. doi: 10.1016/j.medcli.2020.12.041. Epub 2021 Apr 9.
Osteoporotic hip fracture is a relevant pathology due to its prevalence and social and health impact. The aim of this study is to explore the predictive validity of the CUPAX questionnaire on mortality, place of residence and post-fracture functionality.
Prospective observational study. Two hundred and six patients older than 65 years were included, admitted after a hip fracture. The CUPAX questionnaire score was collected before fracture and one year later, and the place of residence and survival at hospital discharge, and after 6 and 12 months. The statistical analysis was carried out with the SAS® 9.4 and Stata® 13.1 programmes.
The median age of the sample was 87.0 years (80.1% women). The in-hospital and one-year mortality rate were 5.8% and 19.1%, respectively. Most of the patients were admitted from home (71.4%), and the most frequent discharge destination was a social health centre (48.2%). The percentage of retention of previous functional level in the total sample was 50%, being higher in the younger patients. The area under the curve ROC for mortality one year later was .697 (95% CI .626-.760) and .659 (95% CI .576-.741) for the discharge destination of patients admitted from home. Evaluation of functional retention one year after the fracture, identified three groups of patients based on the pre-fracture CUPAX value.
These findings support the clinical utility of the CUPAX questionnaire as a predictive functional tool in elderly patients with hip fracture.
骨质疏松性髋部骨折是一种具有较高发病率和社会健康影响的重要疾病。本研究旨在探讨 CUPAX 问卷对死亡率、居住地和骨折后功能的预测效度。
前瞻性观察性研究。共纳入 206 例年龄大于 65 岁的髋部骨折患者。在骨折前和一年后收集 CUPAX 问卷评分，并记录出院时及 6 个月和 12 个月时的居住地和生存情况。统计分析采用 SAS® 9.4 和 Stata® 13.1 程序。
样本的中位年龄为 87.0 岁（80.1%为女性）。住院期间和一年后的死亡率分别为 5.8%和 19.1%。大多数患者从家中入院（71.4%），最常见的出院去向是社会保健中心（48.2%）。在总样本中，保留先前功能水平的比例为 50%，年轻患者的比例更高。一年后死亡率的 ROC 曲线下面积为 0.697（95%CI：0.626-0.760），从家中入院患者的出院去向为 0.659（95%CI：0.576-0.741）。评估骨折一年后功能保留情况，根据骨折前 CUPAX 值将患者分为三组。
这些发现支持 CUPAX 问卷作为一种预测性的功能工具，用于评估老年髋部骨折患者的临床实用性。
