mFI-5联合年龄评分在预测老年髋部骨折术后不良事件及功能恢复中的作用

Role of mFI-5Combined Age Score in Predicting Adverse Events and Functional Recovery After Hip Fracture in Elderly Patients

目的探讨5项改良衰弱指数(5-factor modified frailty index,mFI-5)联合年龄评分预测老年髋部骨折术后不良事件及功能恢复的临床价值。方法分析作者医院2019-01/2022-10月收治的年龄≥60岁行手术治疗的300例髋部骨折患者临床资料。依据患者术后1月内不良事件发生情况分为并发组(n=98)及未并发组(n=202);依据术后半年内是否发生死亡分为死亡组(n=42)及未死亡组(n=258),依据术后半年Harris评分将未死亡组患者分为不良组(n=102)及优良组(n=156);分析各组患者mFI-5评分及mFI-5联合年龄评分;采用受试者工作特征(receiver operating characteristic,ROC)曲线分析mFI-5联合年龄评分预测老年髋部骨折术后1月并发症、半年死亡及髋关节功能恢复的临床价值。结果并发组mFI-5评分及mFI-5联合年龄评分显著高于未并发组(P<0.05);死亡组mFI-5评分及mFI-5联合年龄评分显著高于未死亡组(P<0.05);不良组mFI-5评分及mFI-5联合年龄评分显著高于优良组(P<0.05)。mFI-5联合年龄评分对老年髋部骨折术后并发症、死亡发生及髋关节功能恢复的诊断灵敏度、特异度及曲线下面积(area under the curve,AUC)均较单一mFI-5诊断更高。结论mFI-5及mFI-5联合年龄评分均对老年髋部骨折术后不良事件及髋关节功能恢复具有一定的诊断价值,但mFI-5联合年龄评分的诊断特异度、灵敏度及准确性更高,值得临床广泛使用。

Objective To investigate the clinical value of 5-factor modified frailty index(mFI-5)combined age score in predicting adverse events and functional recovery after hip fracture in elderly patients.Methods The clinical data of 300 elderly patients with hip fracture aged≥60 years who received surgical treatment in author′s hospital from January 2019 to October 2022 were analyzed.Patients were divided into concurrent group(n=98)and non-concurrent group(n=202)according to the occurrence of adverse events within 1 month after surgery;they were divided into death group(n=42)and undead group(n=258)according to whether death occurred within half a year after surgery;patients in undead group were divided into poor group(n=102)and good group(n=156)according to Harris score half a year after surgery;mFI-5 score and mFI-5 combined age score of each group were analyzed;receiver operating characteristic(ROC)curve was used to analyze the clinical value of mFI-5 combined age score in predicting complications 1 month,death half a year and recovery of hip function in elderly patients after hip fracture surgery.Results The mFI-5 score and mFI-5 combined age score in the concurrent group were significantly higher than those in the non-concurrent group(P<0.05);mFI-5 score and mFI-5 combined age score in death group were significantly higher than those in undead group(P<0.05);mFI-5 score and mFI-5 combined age score in poor group were significantly higher than those in good group(P<0.05).The diagnostic sensitivity,specificity and area under the curve(AUC)of mFI-5 combined with age score were higher than those of mFI-5 alone in the diagnosis of postoperative complications,death and recovery of hip function in elderly patients.Conclusion Both mFI-5 and mFI-5 combined age score have certain diagnostic value for adverse events and hip functional recovery after hip fracture surgery in elderly patients,however,mFI-5 combined age score has higher diagnostic specificity,sensitivity and accuracy,and is worthy of wide clinical use.