Tamura Shuntaro, Kamo Tomohiko, Kobayashi Sota, Saito Hiroyuki, Igarashi Tatsuya, Kaizu Yoichi, Miyata Kazuhiro, Kubo Hiroki, Ogihara Hirofumi, Momosaki Ryo
Department of Physical Therapy, Ota College of Medical Technology, 1373 Higashi-nagaoka-cho, Ota, Gunma 373-0812, Japan.
Department of Physical Therapy, Faculty of Rehabilitation, Gunma Paz University, 1-7-1 Tonyamachi, Takasaki-shi, Gunma 370-0006, Japan.
Clin Nutr ESPEN. 2025 Jun;67:355-361. doi: 10.1016/j.clnesp.2025.03.041. Epub 2025 Mar 22.
Older adults with hip fractures of the femur have a higher probability of developing dysphagia after surgery. Dysphagia affects older patients with hip fractures in multiple ways, thus clinicians need to understand the impact of dysphagia on the effectiveness of treatment.
The aim of this study is to clarify the impact of dysphagia on dependence in activities of daily living in older adults with hip fractures.
This retrospective observational study utilized a nationwide inpatient database, encompassing acute inpatient care from 2017 to 2022. Older adults (≥60 years) with hip fractures who underwent surgery and survived to discharge were included. Dysphagia was analyzed as a factor affecting dependence in activities of daily living at discharge using binomial logistic regression and the inverse probability of treatment weighting (IPTW) method, which was based on propensity scores.
The analysis included 88,809 older adults with hip fractures. Binomial logistic regression analysis showed that dysphagia was significantly associated with dependence in activities of daily living, with an odds ratio of 3.24 (95 % confidence interval [CI], 2.72-3.85; p < 0.01). Furthermore, sensitivity analysis confirmed these findings. After adjusting for IPTW, dysphagia remained a significant factor for dependence in activities of daily living at discharge, with an odds ratio of 2.55 (95 % CI, 2.45-2.64; p < 0.01).
In older adults with hip fractures, dysphagia negatively affects the activities of daily living at discharge. These results are useful for clinicians for understanding the significance of preventing dysphagia development.
股骨髋部骨折的老年人术后发生吞咽困难的可能性更高。吞咽困难对髋部骨折的老年患者有多种影响，因此临床医生需要了解吞咽困难对治疗效果的影响。
本研究的目的是阐明吞咽困难对髋部骨折老年人日常生活活动依赖程度的影响。
这项回顾性观察研究利用了一个全国性的住院患者数据库，涵盖了2017年至2022年的急性住院治疗。纳入了接受手术并存活至出院的髋部骨折老年人（≥60岁）。使用二项逻辑回归和基于倾向评分的治疗加权逆概率（IPTW）方法，将吞咽困难作为影响出院时日常生活活动依赖程度的一个因素进行分析。
分析纳入了88,809名髋部骨折的老年人。二项逻辑回归分析显示，吞咽困难与日常生活活动依赖程度显著相关，比值比为3.24（95%置信区间[CI]，2.72 - 3.85；p < 0.01）。此外，敏感性分析证实了这些结果。在对IPTW进行调整后，吞咽困难仍然是出院时日常生活活动依赖程度的一个重要因素，比值比为2.55（95% CI，2.45 - 2.64；p < 0.01）。
在髋部骨折的老年人中，吞咽困难对出院时的日常生活活动有负面影响。这些结果有助于临床医生理解预防吞咽困难发生的重要性。
