老年髋部骨折患者衰弱及营养状况调查分析

Investigation and Analysis of Frailty and Nutritional Status in Elderly Hip Fracture Patients

摘要: 目的：分析老年髋部骨折患者的衰弱现状及主要影响因素。方法：我们采用回顾性调查的方法，评估了2023年1月至2024年4月新疆医科大学第六附属医学院创伤骨一科收治的109例老年髋部骨折患者。通过疲劳、抵抗力、有氧能力、疾病和体重减轻(FRAIL)量表和全球营养不良领导倡议标准来评估衰弱和营养不良的患病率，以分析影响衰弱的因素。结果：共收集了109名老年髋部骨折患者，其中56名(51.38%)衰弱者，53名(48.62%)非衰弱者，57名(52.3%)营养不良。二元相关分析结果表明，衰弱评分与年龄、日常生活活动量表(ADL)评分、体重指数(BMI)、C反应蛋白、血红蛋白(HB)、血清白蛋白(ALK)和血清前白蛋白呈负相关，与ADL评分、BMI、血红蛋白和白蛋白呈负相关(r分别= −0.402，−0.423，−0.186，−0.249；P < 0.05)。多元线性回归分析结果显示，年龄、基础疾病数量、ADL评分、BMI评分和营养状况是衰弱的重要影响因素(P < 0.05)。结论：髋部骨折的老年患者身体素质差且基础疾病多，营养不良的发病率很高。高龄、合并基础疾病和BMI评分低是手术前衰弱的风险因素。

Abstract: Objective: The weakness status and main influencing factors of elderly hip fracture patients were analyzed. Methods: We used a retrospective survey to evaluate 109 elderly hip fracture patients admitted to the First Department of Trauma and Bone of the Sixth Affiliated Medical College of Xinjiang Medical University from January 2023 to April 2024. The prevalence of frailty and malnutrition was assessed by the Fatigue, Resistance, aerobic capacity, Disease and Weight Loss (FRAIL) scale and the Global Malnutrition Leadership Initiative criteria to analyze factors influencing frailty. Results: A total of 109 elderly patients with hip fracture were collected, 56 (51.38%) frail, 53 (48.62%) non-debilitating and 57 (52.3%) were malnourished. Binary correlation analysis showed that frailty score was negatively associated with age, activities of daily living (ADL) score, body mass index (BMI), C reactive protein, hemoglobin (HB), serum albumin (ALK) and serum prealbumin, and ADL score, BMI, hemoglobin and albumin (r = −0.402, −0.423, −0.186, −0.249; P < 0.05). The results of multiple linear regression analysis showed that age, number of underlying diseases, ADL score, BMI score and nutritional status were important factors affecting frailty (P < 0.05). Conclusion: Elderly patients with hip fracture have poor physical quality and many underlying diseases, and have a high incidence of malnutrition. Advanced age, combined underlying disease, and low BMI score are risk factors for preprocedural frailty.