老年髋部骨折患者术后1年行走能力的影响因素分析

Factors affecting walking ability in elderly patients with hip fractures one year after surgery

目的本研究旨在分析老年髋部骨折术后行走能力的独立影响因素。方法回顾性分析广东省人民医院收治的190例老年髋部骨折患者。收集患者的临床资料包括年龄、性别、病史、手术前状况等。术后1年通过电话追踪调查和统一问卷评估患者的步行能力。采用单因素和Logistics多因素回归分析研究结果。结果在190例患者中,52例出现躯体功能损害,发生率为27.4%。躯体功能损害组的血清维生素D水平(Z=3.768)、血红蛋白量(Z=2.603)、血钙(Z=2.065)、血清白蛋白水平(Z=2.267)、术前的行走能力评分(Z=2.517)均显著低于独立行走组。年龄(Z=4.082)、血清β-CTX水平(Z=2.471)、血BUN水平(Z=4.666)、炎性指标(Z=3.251)、疾病负担指数(c2=21.926)等因素在两组之间差异有统计学意义(均P<0.05)。多因素回归分析结果显示,术前血清维生素D水平(OR=0.92)、年龄(OR=1.05)、血BUN水平(OR=1.18)和疾病负担指数(OR=2.80)是老年髋部骨折患者术后行走能力的独立影响因素。结论本研究结果揭示了术前血清维生素D水平、年龄、血BUN水平和Charlson合并症指数对于老年髋部骨折患者术后行走能力的重要影响。这些结果为临床决策和干预提供了可靠的依据,但进一步的研究仍然是必要的,以确定更多的影响因素并建立更准确的预测模型。

Objective This study aimed to analyze the independent factors influencing walking abili-ty in elderly patients after hip fracture surgery.Methods The study population included 190 elderly patients with hip fractures admitted to Guangdong People's Hospital,and a retrospective analysis was conducted.Clini-cal data,including age,gender,medical history,and preoperative conditions,were collected.One year after surgery,patient’swalking ability was assessed through telephone follow-up interviews and standardized ques-tionnaires.Univariate and logistic multivariate regression analyses were utilized to study the results.Results Among the 190 patients,52 experienced physical functional impairment,with an incidence rate of 27.4%.The serum vitamin D level,hemoglobin level,blood calcium level,serum albumin level,and preoperative walking ability score were significantly lower in the physical functional impairment group compared to the indepen-dent walking group.Factors such as age,serumβ-CTX level,blood BUN level,inflammatory indices,and dis-ease burden index showed significant differences between the two groups.The multivariate regression analy-sis revealed that preoperative serum vitamin D level,age,blood BUN level,and disease burden index were in-dependent factors influencing walking ability in elderly patients with hip fractures after surgery.Conclu-sions This study revealed the important influence of preoperative serum vitamin D level,age,blood BUN lev-el,and Charlson comorbidity index on postoperative walking ability in elderly patients with hip fractures.These findings provide reliable evidence for clinical decision-making and interventions,but further research is still necessary to identify additional influencing factors and establish more accurate predictive models.