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初次骨质疏松性骨折后手术时机与再骨折之间的关联。

Association between timing of surgery and refracture after initial osteoporotic fractures.

作者信息

Xu Zhujie, Wang Peng, Qiu Yang, Liu Yi

机构信息

Department of Orthopedics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, Jiangsu, People's Republic of China.

Department of Orthopedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Xuzhou School of Clinical Medicine of Nanjing Medical University, Xuzhou Central Hospital Affiliated to Medical School of Southeast University, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Xuzhou, 221000, Jiangsu, People's Republic of China.

出版信息

Sci Rep. 2025 Jun 6;15(1):19925. doi: 10.1038/s41598-025-04672-3.

Abstract

Osteoporotic refracture may result from multiple risk factors. However, few studies have explored the association between the interval from the initial fracture to surgery (i.e., the timing of surgery) and osteoporotic refracture. This study aims to investigate the significant risk factors of osteoporotic refracture and to provide more reliable interventions for its prevention. A total of 502 hospitalized patients with osteoporotic fractures from January 2017 to December 2022 at Nanjing Medical University Affiliated Wuxi People's Hospital were retrospectively analyzed. This included 52 cases in the refracture group and 450 cases in the non-refracture group. Univariate analysis revealed significant differences between the refracture and non-refracture groups. These differences included age, height, body mass index (BMI), bone mineral density (BMD), hemoglobin concentration, total serum protein concentration, pain level, and the interval from fracture to surgery. Further binary logistic regression and Cox proportional hazard regression both indicated that the interval from fracture to surgery, pain level, and age were independent risk factors for refracture. According to the results of receiver operating characteristic (ROC), the prediction accuracy of interval time was high, with area under ROC (AUC) of 0.782, sensitivity of 63.5%, specificity of 84.4%, and threshold value of 10.5. Our study suggests that a longer interval from initial fracture to surgery is associated with an increased risk of refracture, with 10.5 days being the optimal threshold based on ROC analysis.

摘要

骨质疏松性骨折可能由多种风险因素导致。然而,很少有研究探讨从初次骨折到手术的时间间隔(即手术时机)与骨质疏松性骨折之间的关联。本研究旨在调查骨质疏松性骨折的重要风险因素,并为其预防提供更可靠的干预措施。对2017年1月至2022年12月在南京医科大学附属无锡人民医院住院的502例骨质疏松性骨折患者进行了回顾性分析。其中骨折复发组52例,非骨折复发组450例。单因素分析显示骨折复发组和非骨折复发组之间存在显著差异。这些差异包括年龄、身高、体重指数(BMI)、骨密度(BMD)、血红蛋白浓度、总血清蛋白浓度、疼痛程度以及骨折至手术的时间间隔。进一步的二元逻辑回归和Cox比例风险回归均表明,骨折至手术的时间间隔、疼痛程度和年龄是骨折复发的独立风险因素。根据受试者工作特征(ROC)曲线结果,间隔时间的预测准确性较高,ROC曲线下面积(AUC)为0.782,灵敏度为63.5%,特异度为84.4%,阈值为10.5天。我们的研究表明,从初次骨折到手术的时间间隔越长,骨折复发风险越高,基于ROC分析,10.5天是最佳阈值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9ab/12144287/de1f1183da7f/41598_2025_4672_Fig1_HTML.jpg

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