Tamura Surgical Hospital Department of Rehabilitation, Tamura Surgical Hospital, Kawasaki-shi, Japan.
Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Geriatr Gerontol Int. 2023 Nov;23(11):788-794. doi: 10.1111/ggi.14676. Epub 2023 Sep 21.
The present study examined the relationship between body mass index and the ability to perform the activities of daily living in patients with vertebral compression fractures.
A retrospective cohort analysis of patients aged >65 years hospitalized with a vertebral compression fracture was carried out using a nationwide database in Japan. Body mass index was categorized as underweight (<18.5 kg/m ), normal weight (18.5-22.9 kg/m ), overweight (23.0-27.4 kg/m ) and obese (≥27.5 kg/m ) according to the World Health Organization criteria for the Asia-Pacific region. The primary outcome was Barthel Index gain, namely, the change in the Barthel Index score at discharge from that at admission. Secondary outcomes were the length of hospital stay and readmission within 30 days of discharge.
Among 41 423 participants, 24.5% were classified as underweight, excluding those with missing body mass index data. The underweight group had a significantly lower Barthel Index gain than the normal, overweight and obese groups (median 20 vs 25 vs 30 vs 30, respectively, P < 0.001). The underweight group also had longer hospital stays and higher 30-day readmission rates than the other groups. A multivariable analysis showed that being underweight was independently associated with a Barthel Index gain -3.63 points (95% confidence interval -4.58 to -2.68) lower than normal weight. Furthermore, being underweight was an independent variable affecting the length of hospital stay and readmission within 30 days (P < 0.001).
In patients with vertebral compression fractures, being underweight leads to lower Barthel Index scores, longer hospital stays and increased readmissions within 30 days of discharge. Geriatr Gerontol Int 2023; 23: 788-794.
本研究旨在探讨体重指数与椎体压缩性骨折患者日常生活活动能力之间的关系。
对日本全国数据库中因椎体压缩性骨折住院的年龄＞65 岁患者进行回顾性队列分析。根据世界卫生组织亚太地区标准，将体重指数分为消瘦（＜18.5kg/m²）、正常体重（18.5-22.9kg/m²）、超重（23.0-27.4kg/m²）和肥胖（≥27.5kg/m²）。主要结局指标为巴氏指数（Barthel Index）改善，即出院时与入院时巴氏指数评分的变化。次要结局指标为住院时间和出院后 30 天内再入院率。
在 41423 名参与者中，24.5%的人被归类为消瘦，不包括那些体重指数数据缺失的人。消瘦组的巴氏指数改善明显低于正常体重、超重和肥胖组（中位数分别为 20、25、30、30，P＜0.001）。消瘦组的住院时间也更长，30 天内再入院率也更高。多变量分析显示，消瘦与巴氏指数改善值低 3.63 分（95%置信区间：-4.58 至 -2.68）独立相关，低于正常体重组。此外，消瘦是影响住院时间和出院后 30 天内再入院的独立变量（P＜0.001）。
在椎体压缩性骨折患者中，消瘦导致巴氏指数评分降低、住院时间延长和出院后 30 天内再入院率增加。
