Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study.
Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study.
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DOI：
10.1186/s12891-021-04143-6
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发表时间：
2021-03-09
影响因子：
2.3
通讯作者：
Imagama S
中科院分区：
文献类型：
--
作者：
Iida H;Seki T;Sakai Y;Watanabe T;Wakao N;Matsui H;Imagama S
尽管肌肉减少症已被认为是髋部骨折的危险因素，但只有少数报告描述了肌肉质量对髋部骨折治疗结果的影响。当前的研究旨在调查肌肉质量对髋部骨折治疗结果的影响。这项病例对照研究纳入了337名年龄≥65岁（平均年龄：84.1±7.1岁）的髋部骨折患者（67名男性和270名女性），他们于2013年1月至2019年6月期间接受了骨科手术。平均随访时间为17.1（1-60）个月。入院后，所有患者均根据亚洲肌肉减少症工作组标准（男性，SMI < 7.00 kg/m2；女性，SMI < 5.40kg/m2）使用双能X射线骨密度仪进行低肌肉质量评估。通过学生 t 检验、Mann-Whitney U 检验和 Pearson 卡方检验，比较肌肉质量低的患者和非低肌肉质量患者的治疗结果（在急症护理机构的住院时间、医院死亡率、出院时的 Barthel 指数、出院率和一年死亡率）。使用多变量逻辑回归模型计算与低肌肉质量相关因素的调整优势比 (OR) 和 95% 置信区间 (CI)。绘制了有或没有低肌肉质量的髋部骨折患者一年死亡率的 Kaplan-Meier 生存曲线，并进行了时序检验。此外，我们使用 Cox 比例风险模型确定低肌肉质量是否是髋部骨折患者一年死亡率的危险因素。髋部骨折患者低肌肉质量的患病率为231（68.5%）。肌肉质量低的人巴塞尔指数较低（P<0.0001），出院率较低（P=0.035），一年死亡率较高（P=0.010）。调整年龄和性别的Cox比例风险回归分析发现，低肌肉质量是一年死亡率的危险因素（风险比，3.182，95%置信区间，1.097-9.226，P = 0.033）。肌肉质量低的髋部骨折患者巴塞尔指数较低，出院率较低，一年死亡率较高。此外，低肌肉质量被认为是髋部骨折患者一年死亡的危险因素。上述发现可能有助于临床医生更好地治疗髋部骨折患者。
Although sarcopenia has been known as a risk factor for hip fracture, only a few reports have described the impact of muscle mass on hip fracture treatment outcomes. The current study aimed to investigate the impact of muscle mass on hip fracture treatment outcomes. This case–control study involved 337 patients (67 males and 270 females) with hip fracture aged ≥65 years (mean age: 84.1 ± 7.1 years) who underwent orthopedic surgery from January 2013 to June 2019. The mean follow-up period was 17.1 (1–60) months. Upon admission, all patients were assessed for low muscle mass according to the Asian Working Group for Sarcopenia criteria (male, SMI < 7.00 kg/m2; female, SMI < 5.40 kg/m2) using dual-energy X-ray absorptiometry. Treatment outcomes (stays at acute care institutions, hospital mortality, the Barthel index at discharge, and home discharge rates, and one-year mortality) were compared between patients with and without low muscle mass by Student’s t-test, Mann-Whitney U test and the Pearson Chi-Square test. A multivariate logistic regression model was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for factors related to low muscle mass. Kaplan–Meier survival curves on one-year mortality of hip fracture patients for those with and without low muscle mass were prepared, and log-rank tests were performed. Furthermore, we determined whether low muscle mass was a risk factor for one-year mortality in hip fracture patients using a Cox proportional hazards model. The prevalence of low muscle mass in patients with hip fracture was 231(68.5%). Those with low muscle mass had a lower Barthel index (P < 0.0001), hospital discharge rate (P = 0.035) and higher one-year mortality (P = 0.010). Cox proportional hazards regression analysis adjusted for age and sex found that low muscle mass was a risk factor for one-year mortality (hazard ratio, 3.182, 95% confidence interval, 1.097–9.226, P = 0.033). Patients with hip fracture who had low muscle mass had a lower Barthel index, lower home discharge rate, and higher one-year mortality. Moreover, low muscle mass was identified as a risk factor for one-year mortality among those with hip fracture. The aforementioned findings may help clinicians better manage those with hip fracture.
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影响因子：
7.1
作者：
Bouillanne, O;Morineau, G;Aussel, C
通讯作者：
Aussel, C
影响因子：
3.3
作者：
Tal, Sari;Gurevich, Alexander;Guller, Vladimir
通讯作者：
Guller, Vladimir
影响因子：
3.6
作者：
Denison HJ;Cooper C;Sayer AA;Robinson SM
通讯作者：
Robinson SM
影响因子：
3.3
作者：
Hida, Tetsuro;Ishiguro, Naoki;Harada, Atsushi
通讯作者：
Harada, Atsushi
影响因子：
3.4
作者：
Di Monaco, M;Vallero, F;Cavanna, A
通讯作者：
Cavanna, A