术前 Fried 衰弱表型评估和血清生物标志物对老年股骨颈骨折患者术后 3 个月内全麻预后的预测价值。
Predictive value of preoperative Fried Frailty Phenotype assessment and serum biomarkers on the prognosis of elderly patients with femoral neck fracture under general anesthesia within 3 months after surgery.
机构信息
Department of Anesthesiology, Shenzhen Longhua District People's Hospital, Shenzhen City, China.
Department of Obstetrics, Longhua District Maternity and Child Health Hospital, Shenzhen City, China.
出版信息
Turk J Med Sci. 2023 Dec 11;54(5):1043-1051. doi: 10.55730/1300-0144.5883. eCollection 2024.
BACKGROUND/AIM: Femoral neck fracture (FNF) seriously impact the health of the elderly and affect their long-term quality of life of the patients. This study aimed to determine whether combining the preoperative Fried Frailty Phenotype (FFP) with serum fibroblast growth factor receptor 3 (FGFR3) and run-related transcription factor 2 (RUNX2) could better predict the prognosis of elderly patients with FNF 3 months after surgery.
MATERIALS AND METHODS
A total of 150 elderly patients with FNF (60-89 years old) were enrolled and divided into a nonfrailty cohort and a frailty cohort based on preoperative FFP evaluation. The hip recovery of patients 3 months after surgery was evaluated using Harris Hip Score (HHS). Serum FGFR3 and RUNX2 levels were analyzed, and the relationship between HHS and serum FGFR3 and RUNX2 levels was evaluated. The specificity and sensitivity of FFP, serum FGFR3 and RUNX2 were evaluated using ROC curves before surgery. Potential prognostic factors were analyzed using multivariate logistic regression.
RESULTS
Serum FGFR3 and RUNX2 levels were lower and hip recovery was poorer in the frailty cohort than in the nonfrailty cohort (p < 0.001). Within 3 months after surgery, there were 12 deaths (17.6%) in the frailty cohort and 1 in the nonfrailty cohort (1.2%) (p < 0.001). FFP assessment combined with serum FGFR3 and RUNX2 levels had a higher diagnostic significance. Readmission and preoperative frailty phenotype were independent factors affecting the prognosis of patients with FNF. HHS scores greater than 70 and higher levels of serum FGFR3 and RUNX2 cutoff values (7.85 ng/mL and 56.5 ng/mL, respectively) were identified as protective factors for prognosis.
CONCLUSION
Assessing FFP alongside serum FGFR3 and RUNX2 levels may aid in evaluating the prognosis of elderly patients with FNF 3 months after surgery.
背景/目的：股骨颈骨折（FNF）严重影响老年人的健康，影响其长期生活质量。本研究旨在确定术前 Fried 衰弱表型（FFP）与血清成纤维细胞生长因子受体 3（FGFR3）和与跑步相关的转录因子 2（RUNX2）相结合是否能更好地预测老年 FNF 患者术后 3 个月的预后。
材料和方法
共纳入 150 名 60-89 岁的老年 FNF 患者，根据术前 FFP 评估分为非衰弱组和衰弱组。术后 3 个月，采用 Harris 髋关节评分（HHS）评估患者髋关节恢复情况。分析患者血清 FGFR3 和 RUNX2 水平，评估 HHS 与血清 FGFR3 和 RUNX2 水平的关系。术前采用 ROC 曲线评估 FFP、血清 FGFR3 和 RUNX2 的特异性和敏感性。采用多因素 logistic 回归分析潜在的预后因素。
结果
衰弱组血清 FGFR3 和 RUNX2 水平较低，髋关节恢复较差（p<0.001）。术后 3 个月内，衰弱组有 12 例死亡（17.6%），而非衰弱组有 1 例（1.2%）（p<0.001）。FFP 评估联合血清 FGFR3 和 RUNX2 水平具有更高的诊断意义。再次入院和术前衰弱表型是影响 FNF 患者预后的独立因素。HHS 评分大于 70 分和血清 FGFR3 和 RUNX2 水平较高（分别为 7.85ng/mL 和 56.5ng/mL）为预后的保护因素。
结论
评估 FFP 联合血清 FGFR3 和 RUNX2 水平可能有助于评估老年 FNF 患者术后 3 个月的预后。
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