多维度预后指数与骨折风险：一项在骨关节炎倡议中的 8 年纵向队列研究。
Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative.
机构信息
Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141 90127, Palermo, Italy.
Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.
出版信息
Arch Osteoporos. 2021 Dec 14;17(1):5. doi: 10.1007/s11657-021-01015-3.
UNLABELLED
In this longitudinal study, with a follow-up of 8 years, multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment, significantly predicted the onset of fractures in older people affected by knee osteoarthritis.
PURPOSE
Frailty may be associated with higher fracture risk, but limited research has been carried out using a multidimensional approach to frailty assessment and diagnosis. The present research aimed to investigate whether the MPI, based on comprehensive geriatric assessment (CGA), is associated with the risk of fractures in the Osteoarthritis Initiative (OAI) study.
METHODS
Community-dwellers affected by knee OA or at high risk for this condition were followed-up for 8 years. A standardized CGA including information on functional, nutritional, mood, comorbidity, medication, quality of life, and co-habitation status was used to calculate the MPI. Fractures were diagnosed using self-reported information. Cox's regression analysis was carried out and results are reported as hazard ratios (HRs), with their 95% confidence intervals (CIs), adjusted for potential confounders.
RESULTS
The sample consisted of 4024 individuals (mean age 61.0 years, females = 59.0%). People with incident fractures had a significant higher MPI baseline value than those without (0.42 ± 0.18 vs. 0.40 ± 0.17). After adjusting for several potential confounders, people with an MPI over 0.66 (HR = 1.49; 95%CI: 1.11-2.00) experienced a higher risk of fractures. An increase in 0.10 point in MPI score corresponded to an increase in fracture risk of 4% (HR = 1.04; 95%CI: 1.008-1.07). Higher MPI values were also associated with a higher risk of non-vertebral clinical fractures.
CONCLUSION
Higher MPI values at baseline were associated with an increased risk of fractures, reinforcing the importance of CGA in predicting fractures in older people affected by knee OA.
背景
在这项为期 8 年的纵向研究中，多维预后指数（MPI），一种综合老年评估的产物，显著预测了膝骨关节炎患者骨折的发生。
目的
虚弱可能与更高的骨折风险相关，但使用多维方法进行虚弱评估和诊断的研究有限。本研究旨在探讨基于综合老年评估（CGA）的 MPI 是否与 Osteoarthritis Initiative（OAI）研究中的骨折风险相关。
方法
社区居住的膝骨关节炎患者或有此疾病高风险者随访 8 年。使用标准化的 CGA，包括功能、营养、情绪、合并症、药物、生活质量和共同居住状况信息，计算 MPI。骨折通过自我报告的信息进行诊断。进行 Cox 回归分析，结果以风险比（HR）表示，其 95%置信区间（CI），并调整了潜在混杂因素。
结果
样本包括 4024 名个体（平均年龄 61.0 岁，女性占 59.0%）。发生骨折的患者基线 MPI 值显著高于未发生骨折的患者（0.42±0.18 与 0.40±0.17）。调整多个潜在混杂因素后，MPI 超过 0.66 的患者（HR=1.49；95%CI：1.11-2.00）骨折风险更高。MPI 评分增加 0.10 分，骨折风险增加 4%（HR=1.04；95%CI：1.008-1.07）。MPI 值越高，非椎体临床骨折风险也越高。
结论
基线时较高的 MPI 值与骨折风险增加相关，这强化了 CGA 在预测膝骨关节炎患者骨折中的重要性。
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