老年脆性骨折患者五年随访研究  

A Five-year Follow-up Study on Elderly Patients with Fragility Fractures

作　　者：王冰[1,2] 李芳菲[1] 刘九华 鱼潇雅 李光灿 张春玉[1] Wang Bing;Li Fangfei;Liu Jiuhua;Yu Xiaoya;Li Guangcan;Zhang Chunyu(The Second Affiliated Hospital of Dalian Medical University,Dalian 116027;Six Affiliated Hospital of Shanxi Medical University,Taiyuan 030000)

机构地区：[1]大连医科大学附属第二医院,大连116027 [2]山西医科大学附属第六医院,太原030000

出　　处：《国际老年医学杂志》2024年第3期268-273,共6页International Journal of Geriatrics

基　　金：2022年大连医科大学附属第二医院临床能力提升“1+X”计划临床研究孵化项目(2022LCYJYB19)。

摘　　要：目的观察老年脆性骨折患者五年内再骨折率、死亡率,探讨相关影响因素。方法选取2015年1月―2016年12月于大连医科大学附属第二医院骨科住院的775例老年脆性骨折患者进行回顾性分析。采用电话咨询方式结合医院电子病历系统收集患者五年内再骨折及死亡的情况,采用Cox风险比例模型分析再骨折及死亡的影响。结果五年内有效随访患者634例,五年内总体再骨折率为16.25%(103例),死亡率为32.97%(209例)。Cox多因素回归分析显示:年龄、首次椎体骨折是再骨折发生的独立危险因素(P<0.05),应用抗骨质疏松药物、服用钙剂和(或)维生素D、血肌酐水平是再骨折发生的保护因素(P<0.05);年龄、男性、空腹血糖是死亡的独立危险因素(P<0.05),体质量指数、白蛋白、首次骨折部位为四肢骨折、服用抗骨质疏松药物、服用钙剂和(或)维生素D是死亡的保护因素(P<0.05)。结论老年脆性骨折患者五年内再骨折率、死亡率较高。年龄、首次骨折部位、应用抗骨质疏松药物、服用钙剂和(或)维生素D对再骨折及死亡有影响。Objective To understand the refracture and mortality rate of elderly patients with fragility fractures within 5 years,and in order to identify relevant influencing factors.Methods A retrospective analysis was conducted on 775 elderly patients with brittle fractures admitted to the Orthopedics Department of the Second Affiliated Hospital of Dalian Medical University from January 2015 to December 2016.The patient's refracture and death rates within 5 years were analyzed through telephone consultation combined with the hospital′s electronic medical record system.The impact of refracture and death was analyzed using a Cox risk ratio model.Results 634 patients were effectively followed up within 5 years,with an overall refracture rate of 16.25%(103 cases)and a mortality rate of 32.97%(209 cases)within 5 years.Cox multiple regression analysis showed that age,first vertebral fracture were independent risk factors for refracture(P<0.05),while the use of anti-osteoporosis drugs,calcium supplements and/or vitamin D,and blood creatinine levels were protective factors for refracture(P<0.05);Age,male,and fasting blood glucose were independent risk factors for death(P<0.05),while body mass index,albumin,limb fracture as the first fracture site,taking anti-osteoporosis drugs,calcium supplements,and/or vitamin D were protective factors for death(P<0.05).Conclusion Elderly patients with fragility fractures have a higher rate of refracture and mortality within 5 years.Age,site of first fracture,use of anti-osteoporosis drugs,and use of calcium and/or vitamin D have an impact on refracture and mortality.

关 键 词：老年脆性骨折 再骨折率 死亡率 

分 类 号：R683[医药卫生—骨科学]