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髋关节置换术后行走的总距离可识别患有肌肉减少症的老年患者。

Total Distance Walked After Hip Surgery Identifies Older Patients With Sarcopenia.

作者信息

Marrero-Morales Pablo A, González-Dávila Enrique, Gallego-González Eva M, Marrero-Herrera Pablo, Hernández-Gutiérrez María Fernanda

机构信息

Servicio de Rehabilitación, Complejo Hospitalario Universitario de Canarias, La Laguna, Spain.

Departamento de Medicina Física y Farmacología, Universidad de la Laguna, La Laguna, Spain.

出版信息

Nurs Health Sci. 2025 Jun;27(2):e70169. doi: 10.1111/nhs.70169.

Abstract

This study aims to determine the optimal cut-off point for total walking distance on the day of hospital discharge to identify older adults at high risk of sarcopenia following hip fracture surgery. A prospective observational study included 135 patients aged > 65 years who underwent hip fracture surgery. Logistic regression models were used to predict probable or confirmed sarcopenia based on hospital stay data. Cut-off points were determined using the Youden index, with internal validation through 10-fold cross-validation. The mean age of participants was 81.6 years (SD 7.6), and 72% were women. Sarcopenia was suspected in 33% of patients, with half meeting criteria for confirmed sarcopenia. Walking distance on discharge decreased significantly with increasing sarcopenia severity (p < 0.001). Thresholds of ≤ 8.8 m for women and ≤ 11.3 m for men identified sarcopenia, with positive predictive values of 90% and 62.5%, and negative predictive values of 73.7% and 96.7%, respectively. Alternative models were developed for cases lacking walking distance data. Walking distance at discharge is a simple, practical, and effective marker for identifying sarcopenia in older adults after hip fracture surgery.

摘要

本研究旨在确定出院当天总步行距离的最佳切点,以识别髋部骨折手术后存在肌肉减少症高风险的老年人。一项前瞻性观察性研究纳入了135例年龄>65岁且接受髋部骨折手术的患者。基于住院数据,使用逻辑回归模型预测可能或确诊的肌肉减少症。使用约登指数确定切点,并通过10倍交叉验证进行内部验证。参与者的平均年龄为81.6岁(标准差7.6),72%为女性。33%的患者疑似患有肌肉减少症,其中一半符合确诊肌肉减少症的标准。随着肌肉减少症严重程度的增加,出院时的步行距离显著降低(p<0.001)。女性≤8.8米和男性≤11.3米的阈值可识别肌肉减少症,阳性预测值分别为90%和62.5%,阴性预测值分别为73.7%和96.7%。针对缺乏步行距离数据的病例开发了替代模型。出院时的步行距离是识别髋部骨折手术后老年人肌肉减少症的一个简单、实用且有效的指标。

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