Tsutsui Tomoko, Fujiwara Toshifumi, Matsumoto Yoshihiro, Kimura Atsushi, Kanahori Masaya, Arisumi Shinkichi, Oyamada Akiko, Ohishi Masanobu, Ikuta Ko, Tsuchiya Kuniyoshi, Tayama Naohisa, Tomari Shinji, Miyahara Hisaaki, Mae Takao, Hara Toshihiko, Saito Taichi, Arizono Takeshi, Kawano Tsutomu, Mawatari Taro, Fujiwara Masami, Takasaki Minoru, Shin Kunichika, Ninomiya Kenichi, Nakaie Kazutoshi, Antoku Yasuaki, Iwamoto Yukihide, Nakashima Yasuharu
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Orthopaedic Surgery, Saga Handicapped Children's Hospital, Saga, Japan.
J Bone Miner Metab. 2025 Jul 2. doi: 10.1007/s00774-025-01615-w.
Fragility hip fracture (FHF) has been frequently seen in trauma of older people, resulted in decreased mobility and a loss of independence.
This study retrospectively assessed the long-term health-related quality of life (HRQOL) and living arrangement in older patients following FHF, and evaluated the factors associating with long-term EuroQol 5D (EQ5D) for 5 years or more. This study included 203 Japanese patients (male 26, female 177) with FHF over the age of 60 years. We examined the long-term EQ5D and life style at final follow-up, and identified the factors affecting with EQ5D.
The mean age at baseline of 79 years, the mean observation duration was 6 years, and the average value of EQ5D at final follow-up was 0.65. Multivariate analysis presented that EQ5D at final follow-up was significantly predicted by serum albumin, trochanteric fracture, comorbidity stroke, higher BI at post-admission, less length of stay hospital, and living at home at final follow-up. The people living at home at final follow-up (148/203 [72.9%]) was less than the people at baseline (190/203 [93.6%]). In multivariate analysis, the people living at home at final follow-up were younger age at baseline, and higher BI at post-admission.
In conclusion the long-term EQ5D after FHF was decreased in patients with lower serum albumin at baseline, with trochanteric fracture, with stroke comorbidity, and with lower BI at post-admission. The people living at home after FHF were young age at baseline and high BI at post-admission.
髋部脆性骨折（FHF）在老年人创伤中较为常见，会导致活动能力下降和失去独立生活能力。
本研究回顾性评估了老年髋部脆性骨折患者的长期健康相关生活质量（HRQOL）和生活安排，并评估了与5年及以上长期欧洲五维健康量表（EQ5D）相关的因素。本研究纳入了203名60岁以上的日本髋部脆性骨折患者（男性26例，女性177例）。我们在末次随访时检查了长期EQ5D和生活方式，并确定了影响EQ5D的因素。
基线时的平均年龄为79岁，平均观察期为6年，末次随访时EQ5D的平均值为0.65。多因素分析显示，末次随访时的EQ5D由血清白蛋白、转子间骨折、合并中风、入院后较高的巴氏指数（BI）、较短的住院时间以及末次随访时在家居住显著预测。末次随访时在家居住的人数（148/203 [72.9%]）少于基线时（190/203 [93.6%]）。在多因素分析中，末次随访时在家居住的人在基线时年龄较小，入院后BI较高。
总之，基线时血清白蛋白水平较低、患有转子间骨折、合并中风以及入院后BI较低的髋部脆性骨折患者，其长期EQ5D会降低。髋部脆性骨折后在家居住的人在基线时年龄较小且入院后BI较高。
