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血清维生素 D 水平低显著增加髋部骨折老年患者的死亡风险:一项前瞻性队列研究。

Low serum levels of vitamin D significantly increase the risk of death in older adults with hip fractures: a prospective cohort.

机构信息

- Universidade Luterana do Brasil - Canoas - RS - Brasil.

- Universidade Federal do Rio Grande do Sul - Porto Alegre - RS - Brasil.

出版信息

Rev Col Bras Cir. 2022 Apr 1;49:e20223054. doi: 10.1590/0100-6991e-20223054. eCollection 2022.

Abstract

OBJECTIVE

to evaluate the relationship between 25(OH)D3 levels and fatal outcome in patients over 60 years of age undergoing surgical repair of hip fractures.

METHODS

prospective cohort of patients undergoing surgical repair of hip fractures. At admission, 25(OH)D3 levels were measured, among other parameters. Patients were followed for at least 1 year, and incident mortality was recorded.

RESULTS

209 patients were included in the study, with a mean age of 79.5 ± 7.6 years among survivors and 80.7 ± 8.2 years among those who died in the first postoperative year (p=0.346). The 25(OH)D3 levels of survivors were significantly higher than those of patients who died (p=0.003). After adjusting for confounding variables, 25(OH)D3 levels below 12.5ng/mL were significant risk factors regardless of mortality (adjusted OR: 7.6; 95% CI: 2.35 to 24.56).

CONCLUSIONS

our data show that serum 25(OH)D3 levels below 12.5ng/mL significantly and independently increased the risk of mortality in the first year after surgical repair of low-energy hip fracture in patients over 60 years of age in the geographic region where this study was conducted. Low albumin also showed a significant association with mortality in these patients. All other factors had no significant associations.

摘要

目的

评估 25(OH)D3 水平与 60 岁以上接受髋关节骨折手术修复患者的死亡结局之间的关系。

方法

对接受髋关节骨折手术修复的患者进行前瞻性队列研究。在入院时,测量了 25(OH)D3 水平等参数。对患者进行了至少 1 年的随访,并记录了发生的死亡率。

结果

研究纳入了 209 名患者,幸存者的平均年龄为 79.5±7.6 岁,而在术后第 1 年死亡的患者的平均年龄为 80.7±8.2 岁(p=0.346)。幸存者的 25(OH)D3 水平明显高于死亡患者(p=0.003)。在调整混杂变量后,25(OH)D3 水平低于 12.5ng/mL 是无论死亡率如何的显著危险因素(调整后的 OR:7.6;95%CI:2.35 至 24.56)。

结论

我们的数据表明,在进行研究的地理区域内,60 岁以上接受低能量髋关节骨折手术修复的患者中,血清 25(OH)D3 水平低于 12.5ng/mL 显著且独立地增加了术后第 1 年的死亡率。低白蛋白血症也与这些患者的死亡率显著相关。所有其他因素均与死亡率无显著相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1a3/10578824/5b6b2fd4be8b/rcbc-49-e20223054-g001.jpg

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