| 姚宝红,金博,高晓云,刘亚男,李光灿,张春玉.老年脆性骨折患者再次骨折的危险因素[J].中华老年多器官疾病杂志,2023,22(4):241~245 |
| 老年脆性骨折患者再次骨折的危险因素 |
| Risk factors for refractures in elderly patients after fragility fracture |
| 投稿时间：2022-10-16 |
| DOI：10.11915/j.issn.1671-5403.2023.04.050 |
| 中文关键词: 老年人 骨质疏松 脆性骨折 再次骨折 危险因素 |
| 英文关键词:aged osteoporosis fragility fracture refracture risk factors This work was supported by the National Key Research and Development Program of China |
| 基金项目:国家重点研发计划(2018YFC2002100,2018YFC2002104)；大连医科大学附属第二医院科研临床能力提升“1+X”计划临床研究孵化项目(2022LCYJYB19) |
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| 中文摘要: |
| 目的 探讨老年骨质疏松性骨折患者再次骨折的危险因素,为避免再次骨折发生提供理论依据。方法 回顾性分析2015年1月至2019年12月大连医科大学附属第二医院骨科收治的1315例骨质疏松性骨折住院患者的临床资料(年龄≥60岁),根据既往骨折情况,将患者分首次骨折组(n=1038)和再次骨折组(n=277)。比较2组患者的一般资料和血液生化指标情况。采用SPSS 25.0统计软件进行数据分析。根据数据类型,分别采用t检验、Mann-Whitney U检验或χ2检验进行组间比较。采用多元logistic回归分析影响老年脆性骨折患者再次骨折的危险因素。结果 首次骨折组年龄低于再次骨折组[(73.31±9.01)和(76.26±8.11)岁]；首次骨折组女性占比低于再次骨折组(74.40%和83.00%),差异均有统计学意义(P<0.05)。骨折的常见诱因依次为跌倒(81.29%)、无诱因(7.07%)、腰背部负重(6.24%)、体位改变或扭伤(5.40%)。在院期间骨质疏松症总体诊断率为13.00%,钙剂、维生素D、双磷酸盐类使用率分别为12.50%、8.80%与4.90%。再次骨折的危险因素包括高龄(OR=1.022)、血磷值增高(OR=3.220)、血红蛋白偏低(OR=0.983)、低血糖(OR=0.938)、血肌酐降低(OR=0.995)、白蛋白减少(OR=0.950)及合并慢性阻塞性肺疾病(OR=2.214)。结论 高龄、血磷值增高、血红蛋白偏低、低血糖、血肌酐降低、血清白蛋白减少、合并慢性阻塞性肺疾病的患者再次骨折风险增高。老年骨质疏松骨折患者住院期间,骨质疏松症诊断及治疗率均偏低。 |
| 英文摘要: |
| Objective To explore the risk factors of recurrent fracture in elderly patients with osteoporotic fracture in order to provide theoretical basis for prevention of recurrent fracture. Methods The clinical data of 1 315 inpatients (aged ≥60 years) with osteoporotic fracture admitted in Department of Orthopaedics of Second Affiliated Hospital of Dalian Medical University from January 2015 to December 2019 were collected. According to the previous history of fracture, they were divided into first fracture group and refracture group (n=277). General data and blood biochemical parameters were compared between the two groups. SPSS statistics 25.0 was used to perform the statistical analysis. Student′s t test, Mann-Whitney U test or Chi-square test was employed for intergroup comparison depending on data type. Multivariate logistic regression analysis was adopted to analyze the risk factors affecting refracture in elderly patients with fragility fracture. Results The patients from the first fracture group were younger [(73.31±9.01) vs (76.26±8.11) years]and had lower proportion of females (74.40% vs 83.00%) than those in the refracture group (P<0.05). The most common causes of fracture were fall (81.29%), no inducement (7.07%), low-back load (6.24%) and change in body posture or sprain (5.40%). The overall diagnosis rate of osteoporosis was 13.00% in elderly patients with osteoporotic fracture during hospitalization. The utilization rate of calcium, vitamin D and bisphosphate drugs was 12.50%, 8.80% and 4.90%, respectively. The risk factors of refracture include advanced age (OR=1.022), elevated blood phosphorus (OR=3.220), low hemoglobin (OR=0.983), hypoglycemia (OR=0.938), low serum creatinine (OR=0.995), hypoalbuminemia (OR=0.950) and complicated with chronic obstructive pulmonary disease (COPD) (OR=2.214). Conclusion The elderly with advanced age, higher blood phosphorus, lower hemoglobin, hypoglycemia, low serum creatinine, hypoalbuminemia and complicated with COPD are at high risk for refracture. The diagnosis and treatment rates of osteoporosis are quite low in the elderly patients with osteoporotic fractures during hospitalization. |
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