基于血清肌酐和胱抑素 C 的肌少症指数预测老年人髋部骨折手术后术后并发症的风险。
Sarcopenia index based on serum creatinine and cystatin C predicts the risk of postoperative complications following hip fracture surgery in older adults.
机构信息
Zigong Mental Health Center, Zigong, Sichuan Province, China.
Department of Guideline and Rapid Recommendation, Cochrane China Center, MAGIC China Center, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
出版信息
BMC Geriatr. 2021 Oct 12;21(1):541. doi: 10.1186/s12877-021-02522-1.
OBJECTIVE
To assess the utility of the preoperative Sarcopenia index (SI) as a predictive marker of the risk of postoperative complications following hip fracture surgery in older adults.
STUDY DESIGN
This observational study enrolled older adults with hip fracture who were hospitalized in the Department of Orthopedics of West China Hospital, Sichuan University, from December 7, 2010 - June 14, 2017, and who underwent hip fracture surgery.
PRIMARY OUTCOME AND MEASURES
Clinical data were collected from medical records and serum creatinine and cystatin C were measured before surgery. Outcomes included postoperative complications such as pneumonia, urinary tract infection, respiratory failure, heart failure, and non-grade A healing. Binary logistic regression analyses were used to analyze association between SI and postoperative complications.
RESULTS
A total of 897 patients aged 60 years and over were enrolled in this study (age range: 60 - 100 years), of whom 306(34.1%)were male, and 591(65.9%)were female. Postoperative complications included pneumonia (12%), urinary tract infections (1.8%), respiratory failure (1.5%), heart failure (1.6%), and non-A- grade healing (3.6%). In the patient group that received joint replacements, the incidence of pneumonia was negatively associated with SI values. After adjusting for potential confounding factors, binary logistic regression analyses showed that a higher SI was independently associated with a lower risk of pneumonia after joint replacement surgery (OR:0.39, 95% CI:0.18-0.89, P<0.05). However, we did not find statistically significant association between SI and the risk of postoperative complications other than pneumonia among patients with two types of hip fracture surgery.
CONCLUSION
The SI based on serum creatinine and cystatin C can predict pneumonia rather than other postoperative complications among older patients with hip fracture after joint replacement surgery.
目的
评估术前肌少症指数（SI）作为预测老年人髋部骨折手术后发生术后并发症风险的指标的作用。
研究设计
本观察性研究纳入了 2010 年 12 月 7 日至 2017 年 6 月 14 日期间在四川大学华西医院骨科住院并接受髋部骨折手术的老年髋部骨折患者。
主要结果和测量指标
从病历中收集临床数据，并在手术前测量血清肌酐和胱抑素 C。结果包括肺炎、尿路感染、呼吸衰竭、心力衰竭和非 A 级愈合等术后并发症。使用二元逻辑回归分析来分析 SI 与术后并发症之间的关系。
结果
本研究共纳入 897 名 60 岁及以上的患者（年龄范围：60-100 岁），其中 306 名（34.1%）为男性，591 名（65.9%）为女性。术后并发症包括肺炎（12%）、尿路感染（1.8%）、呼吸衰竭（1.5%）、心力衰竭（1.6%）和非 A 级愈合（3.6%）。在接受关节置换的患者组中，肺炎的发生率与 SI 值呈负相关。调整潜在混杂因素后，二元逻辑回归分析表明，较高的 SI 与关节置换手术后肺炎的风险降低独立相关（OR：0.39，95%CI：0.18-0.89，P<0.05）。然而，我们没有发现 SI 与两种类型髋部骨折手术后除肺炎以外的其他术后并发症风险之间存在统计学显著关联。
结论
基于血清肌酐和胱抑素 C 的 SI 可以预测接受关节置换的老年髋部骨折患者术后肺炎的发生，而不能预测其他术后并发症。
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