Ruiz Romero María Victoria, Calero Bernal María Luz, Carranza Galván Ana Belén, Blanco Taboada Ana Laura, Fernández Moyano Antonio, Fernández Ojeda María Rocío
Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe (Bormujos). Sevilla. España.
Servicio de Medicina Interna, Hospital San Juan de Dios del Aljarafe (Bormujos). Sevilla. España.
Rev Esp Salud Publica. 2022 Jul 26;96:e202207057.
Hip fracture (HF) in the elderly carries high mortality and decreases functionality and quality of life after one year. The aim of this paper was to identify risk factors that influenced functionality (Barthel) and quality of life (EQ-5D) of the elderly with osteoporotic HF.
A prospective observational study was made in people over 65 years of age with HF between October 2017 and November 2018. Clinical information was collected from the digital medical record and the scales were measured by telephone at four times: baseline, one month, six months and twelve months. Statistical analysis was made thanks to SPSS vs 25.0. Multivariate analysis was performed using a generalized linear model for repeated measures to determine the relationship of risk factors with functionality and quality of life.
Functionality showed significant differences (p<0.001) between baseline measurement and one month (90 points vs 50); baseline and at twelve months (90 vs 60 points); and that of the month and at twelve months (50 points vs 60). Quality of life also presented significant differences (p<0.001) between baseline and one month (0.587 vs 0.113); and baseline and twelve months (0.220). The functionality should be in transfused and with high surgical risk (p<0.05) and the quality of life will arrive in high surgical risk (p=0.017). Those older than 85 years were the ones who recovered the least after one year, as well as patients with delirium on admission and those who received transfusions. Patients with iron therapy recovered better at six months compared to those who did not and maintained this improvement at twelve months.
Among the main risk factors are advanced age, male sex, transfused, high surgical risk, delirium on admission and malnutrition.
老年髋部骨折（HF）死亡率高，且会导致患者一年后的功能及生活质量下降。本文旨在确定影响老年骨质疏松性HF患者功能（Barthel指数）和生活质量（EQ-5D量表）的危险因素。
对2017年10月至2018年11月期间65岁以上的HF患者进行前瞻性观察研究。从电子病历中收集临床信息，并通过电话在四个时间点测量量表：基线、1个月、6个月和12个月。使用SPSS 25.0进行统计分析。采用重复测量的广义线性模型进行多变量分析，以确定危险因素与功能和生活质量之间的关系。
功能在基线测量与1个月时（90分对50分）、基线与12个月时（90分对60分）以及1个月与12个月时（50分对60分）显示出显著差异（p<0.001）。生活质量在基线与1个月时（0.587对0.113）以及基线与12个月时（0.220）也呈现出显著差异（p<0.001）。功能较差且手术风险高者（p<0.05），生活质量在手术风险高者中也较差（p=0.017）。85岁以上的患者在1年后恢复最差，入院时伴有谵妄的患者以及接受输血的患者也是如此。接受铁剂治疗的患者在6个月时比未接受治疗的患者恢复得更好，并在12个月时维持了这种改善。
主要危险因素包括高龄、男性、输血、手术风险高、入院时谵妄和营养不良。
