Body Mass Index and Risk of Adverse Cardiac Events in Elderly Patients with Hip Fracture: A Population-Based Study
Body Mass Index and Risk of Adverse Cardiac Events in Elderly Patients with Hip Fracture: A Population-Based Study
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DOI：
10.1111/j.1532-5415.2008.02141.x
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发表时间：
2009-03-01
影响因子：
6.3
通讯作者：
McMahon, M. Molly
中科院分区：
文献类型：
--
作者：
Batsis, John A.;Huddleston, Jeanne M.;McMahon, M. Molly
确定肥胖是否影响髋部骨折修复后的心脏并发症。基于人群的历史研究，使用来自罗切斯特流行病学项目的数据。明尼苏达州奥姆斯特德县。所有1988年到2002年间髋部骨折的紧急修复。身体质量指数（BMI）分为体重不足（< 18.5 kg/m(2)）、正常体重（18.5-24.9 kg/m(2)）、超重（25.0-29.9 kg/m(2)）和肥胖（>= 30 kg/m(2)）。术后心脏并发症定义为心肌梗死、心绞痛、充血性心力衰竭或手术后1年内新发心律失常。对每个结局的发生率进行估计，并使用Cox比例风险模型对年龄、性别、手术年份、β受体阻滞剂的使用和修订心脏风险指数进行调整，评估总体心脏并发症。接受髋部骨折修复的患者有体重不足184例（15.6%），正常体重640例（54.2%），超重251例（21.3%），肥胖105例（8.9%）（平均年龄84.2±7.5岁，80%为女性）。所有组的基线美国麻醉医师协会（ASA）状态相似（ASA I/II vs III-V， P= 0.14）。体重过轻的患者发生心肌梗死的风险明显较高(优势比（OR） 1.44, 95%可信区间(CI)=1.0-2.1；P= 0.05)和心律失常（OR=1.59, 95% CI=1.0-2.4； P= 0.04）明显低于正常体重患者。多因素分析表明，体重过轻的患者发生任何类型的不良心脏事件的风险更高(OR=1.56, 95% CI=1.22-1.98
To determine whether obesity affects cardiac complications after hip fracture repair.A population-based historical study using data from the Rochester Epidemiology Project.Olmsted County, Minnesota.All urgent hip fracture repairs between 1988 and 2002.Body mass index (BMI) was categorized as underweight (< 18.5 kg/m(2)), normal-weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (>= 30 kg/m(2)). Postoperative cardiac complications were defined as myocardial infarction, angina pectoris, congestive heart failure, or new-onset arrhythmias within 1-year of surgery. Incidence rates were estimated for each outcome, and overall cardiac complications were assessed using Cox proportional hazards models adjusted for age, sex, year of surgery, use of beta-blockers, and the Revised Cardiac Risk Index.Hip fracture repairs were performed in 184 (15.6%) underweight, 640 (54.2%) normal-weight, 251 (21.3%) overweight, and 105 (8.9%) obese subjects (mean age 84.2 +/- 7.5; 80% female). Baseline American Society of Anesthesiologists (ASA) status was similar in all groups (ASA I/II vs III-V, P=.14). Underweight patients had a significantly higher risk of developing myocardial infarction (odds ratio (OR) 1.44, 95% confidence interval (CI)=1.0-2.1; P=.05) and arrhythmias (OR=1.59, 95% CI=1.0-2.4; P=.04) than normal-weight patients. Multivariate analysis demonstrated that underweight patients had a higher risk of developing an adverse cardiac event of any type (OR=1.56, 95% CI=1.22-1.98; P