Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan.
Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
J Orthop Sci. 2023 Mar;28(2):380-384. doi: 10.1016/j.jos.2021.12.009. Epub 2022 Jan 6.
Several studies in older patients with femoral neck fracture found that preoperative anemia and malnutrition were associated with higher mortality and poorer physical function. Therefore, we compared nutritional status, Hb level, and renal function in women with femoral neck fracture and women of the same age with osteoarthritis of the hip joint.
We enrolled 257 women aged 70 years and older who suffered femoral neck fracture (F group) or who were scheduled to undergo total hip arthroplasty for osteoarthritis of the hip joint (OA group). The F and OA groups were further divided into 2 groups on the basis of age, ie, 74 years old and younger (F70 and OA70) and 75 years old and older (F75 and OA75). To assess whether patients had undernutrition, mortality risk, anemia, and renal dysfunction, we assessed Geriatric Nutritional Risk Index (GNRI), Hb, and eGFR.
We found a significant difference in the mean Hb levels and GNRI scores between the F75 and OA75 and F70 and OA70. Moreover, we found a moderate correlation between Hb level and GNRI score in the F75 and OA75. With respect to the GNRI category, the percentage of patients at moderate or major risk was 42.1% in the F70 group and 57.6% in the F75 group but only 1.9% in the OA70 group and 4.3% in the OA75 group.
We found that women with femoral neck fracture had significantly lower Hb levels and lower GNRI scores than women with hip OA in the same age and that anemia and undernutrition were closely linked in women aged 75 and above. Moreover, we found that more than 40% of patients with a femoral neck fracture had a moderate to major risk on the basis of their GNRI scores.
几项针对股骨颈骨折老年患者的研究发现,术前贫血和营养不良与更高的死亡率和更差的身体功能相关。因此,我们比较了患有股骨颈骨折和同龄髋关节骨关节炎的女性的营养状况、Hb 水平和肾功能。
我们纳入了 257 名 70 岁及以上患有股骨颈骨折(F 组)或因髋关节骨关节炎接受全髋关节置换术的女性(OA 组)。F 组和 OA 组根据年龄进一步分为 2 组,即 74 岁及以下(F70 和 OA70)和 75 岁及以上(F75 和 OA75)。为了评估患者是否存在营养不良、死亡风险、贫血和肾功能障碍,我们评估了老年营养风险指数(GNRI)、Hb 和 eGFR。
我们发现 F75 和 OA75 与 F70 和 OA70 之间的平均 Hb 水平和 GNRI 评分存在显著差异。此外,我们发现 F75 和 OA75 之间 Hb 水平和 GNRI 评分之间存在中度相关性。就 GNRI 类别而言,F70 组中度或重度风险的患者比例为 42.1%,F75 组为 57.6%,而 OA70 组仅为 1.9%,OA75 组为 4.3%。
我们发现,在相同年龄的女性中,患有股骨颈骨折的女性的 Hb 水平和 GNRI 评分明显低于患有髋关节骨关节炎的女性,并且 75 岁及以上的女性贫血和营养不良密切相关。此外,我们发现,根据 GNRI 评分,40%以上的股骨颈骨折患者存在中度至重度风险。