肌少症对股骨粗隆间骨折术后早期预后的影响

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Abstract Objective: To determine the association of sarcopenia with short-term postoperative function after internal fixation for femoral intertrochanteric fractures. Methods: A total of 201 patients with intertrochanteric fractures who underwent intramedullary fixation in the First Affiliated Hospital of Wenzhou Medical University from May 2013 to January 2017 were analyzed retrospectively. The general conditions of the patients were collected before surgery, and the appendicular skeletal muscle index and grip strength were measured. The clinical prognosis was followed up, including postoperative complications, Barthel index (6 months after surgery), hospitalization expenses, hospitalization time, etc. Univariate andmultivariate logistic regression analysis was used. Draw a ROC curve and calculate the area under the curve. Results: Sarcopenia was present in 98 patients (48.8%), who had a higher risk of postoperative infection (χ2=4.430, P=0.035), cardiopulmonary complication (χ2=4.232, P=0.04), and lower Barthel Index (Z=-8.804, P<0.05) compared with non-sarcopenic patients. According to the comparison between 6 months postoperative and preoperative Barthel index, the patients were divided into the functional recovery group and the incomplete recovery group. The comparison between the groups indicated that (χ2=23.213, P<0.001), low vitamin D (t=-1.752, P=0.083), low bone density (t=2.774, P=0.006), advanced age (t=-4.678, P<0.001), lower extremity venous thrombosis (χ2=5.635, P=0.018) were possible factors related to incomplete functional recovery. Binary logistic regression analysis suggested sarcopenia (OR=2.918, 95%CI=1.300-6.553, P=0.09), advanced age (OR=1.041, 95%CI=1.009-1.074, P=0.012) and thrombosis (OR=5.177, 95%CI=1.090-24.59, P=0.039) were risk factors for incomplete recovery of postoperative function. ROC curve analysis indicated the area under the curve of sarcopenia and age were 0.320 (P<0.001) and 0.702 (P<0.001) separately. Conclusion: Patients with trochanteric fracture have a higher incidence of sarcopenia, which is an important risk factor for poor prognosis in patients with intertrochanteric fractures.

Key words： sarcopenia femoral intertrochanteric fractures internal fixation risk factors ROC curve

Received: 03 April 2018

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	LANG Junzhe
	JIN Jianfeng
	WU Congcong
	WU Peng
	CHEN Lei.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I11/822

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