老年髋部脆性骨折患者术后衰弱相关危险因素分析

Relationship between obstructive sleep apnea hypopnea syndrome and postoperative frailty in elderly patients with fragility hip fracture

目的分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与老年髋部脆性骨折患者术后衰弱的关系。方法采用1∶3巢式病例对照研究,选取2018年4月至2021年1月在海南省人民医院就诊的160例老年髋部脆性骨折患者作为研究对象(其中40例伴OSAHS)。根据术后1年是否发生衰弱将其分为2组:衰弱组(n=86)和非衰弱组(n=74)。用Logistic回归分析OSAHS与老年髋部脆性骨折术后衰弱的关系。结果衰弱组的高血压、糖尿病、抑郁、营养不良、认知功能障碍和OSAHS人数占比高于非衰弱组,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示高血压、糖尿病、抑郁、认知功能障碍和OSAHS均是老年髋部脆性骨折术后衰弱的独立危险因素(P<0.05)。结论OSAHS是老年髋部脆性骨折术后衰弱的独立危险因素。对于伴有OSAHS的老年髋部脆性骨折患者,应加以重视,避免并发衰弱。

Objective To analyze the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)and postoperative frailty in elderly patients with fragility hip fracture.Methods A 1:3 nest-controlled case-control study was conducted in 160 elderly patients with fragility hip fracture who were admitted to Hainan Provincial People’s Hospital,Affiliated to Hainan Medical C.ollege from April 2018 to January 2021 were recruited as study subjects.40 of them were diagnosed to have OSAHS.Depending on whether or not frailty occurred 1 year after surgery,the patients were divided into two groups:the frailty group(n=86)and the nonfrailty group(n=14).Logistic regression was used to analyze the relationship between OSAHS and postoperative frailty in elderly patients with fragility hip fracture.Results The proportion of hypertension,diabetes,depression,malnutrition,cognitive dysfunction and OSAHS in the frailty group were higher than those in the non-frailty group,with statistical significance(P<0.05).Logistic regression analysis further revealed that hypertension,diabetes,depression,cognitive dysfunction and OSAHS were all independent risk factors for postoperative frailty in the elderly patients with fragility hip fracture(P<0.05).Conclusion OSAHS is an independent risk factor for postoperative frailty in the elderly patients with fragility hip fracture.Attention should be paid to those elderly fragility hip fracture patients with OSAHS,so as to avoid concomitant frailty.