Jain G, Vadivelu G, Krishna A, Malhotra R, Sharma V, Farooque K
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
Department of Orthopaedics, SGT Medical College Hospital and Research Institute, Gurugram, India.
Malays Orthop J. 2023 Mar;17(1):1-9. doi: 10.5704/MOJ.2303.001.
The objective of the current study was to test our hypothesis that older patients sustaining high energy trauma need to be evaluated for their comorbidities similar to geriatric patients sustaining low energy trauma.
This study was a retrospective-prospective analysis of 173 patients of more than 50 years of age enrolled between November 2017 and December 2018. Herewith, we have compared retrospectively collected laboratory investigations of 124 fragility fracture patients with prospectively collected laboratory investigations of 49 patients with high energy trauma. The laboratory investigations, including the liver function tests, renal function tests, indices of calcium metabolism, serum electrolytes, complete blood counts, and bone mineral density (BMD) scores.
Both groups were similar to each other as far as baseline demographic characteristics were concerned. The proportion of female patients and patients with non-osteoporotic range BMD (T-score >-2.5) was significantly higher in the high-energy fracture group (P value <0.05). Hypoalbuminemia (<3.4gm/dl) 17.3%, abnormalities sodium (<135mmol/L or >148mmol/L) 23.2%, Anaemia (<10g/dl) 12.7%, Hypercalcemia (>10.4mg/dl) 16.3%, Vitamin D deficiency (<20ng/ml) 17.3% are the common laboratory abnormality found in study population. No statistically significant difference was found among the two groups in terms of laboratory investigation abnormalities.
The laboratory investigation abnormality in an older patient with a clinical fracture is independent of the mechanism of injury. The results of the current study emphasise the need for a comprehensive laboratory workup in older patients with either high- energy fractures or fragility fractures.
本研究的目的是检验我们的假设，即遭受高能量创伤的老年患者需要像遭受低能量创伤的老年患者一样，对其合并症进行评估。
本研究是对2017年11月至2018年12月期间纳入的173例50岁以上患者进行的回顾性-前瞻性分析。在此，我们将124例脆性骨折患者回顾性收集的实验室检查结果与49例高能量创伤患者前瞻性收集的实验室检查结果进行了比较。实验室检查包括肝功能检查、肾功能检查、钙代谢指标、血清电解质、全血细胞计数和骨密度（BMD）评分。
就基线人口统计学特征而言，两组彼此相似。高能量骨折组女性患者和骨密度处于非骨质疏松范围（T值＞-2.5）的患者比例显著更高（P值＜0.05）。低白蛋白血症（＜3.4g/dl）17.3%、钠异常（＜135mmol/L或＞148mmol/L）23.2%、贫血（＜10g/dl）12.7%、高钙血症（＞10.4mg/dl）16.3%、维生素D缺乏（＜20ng/ml）17.3%是研究人群中常见的实验室异常情况。两组在实验室检查异常方面未发现统计学显著差异。
临床骨折的老年患者的实验室检查异常与损伤机制无关。本研究结果强调了对患有高能量骨折或脆性骨折的老年患者进行全面实验室检查的必要性。
