| ObjectiveIn this study,the clinical data of elderly patients with hip fracture were collected to understand the current situation of diagnosis and treatment of osteoporosis in elderly patients with hip fracture,and the related factors of re-fracture in elderly patients with hip fracture were analyzed.to provide clinical basis for the prevention of re-fracture in elderly patients with hip fracture.MethodTo collect the medical records of 566 patients with hip fracture from January 2019 to December 2022,including name,gender,age,height,weight,cause of fracture,fracture site,surgical method,hospitalization time,preoperative diagnosis,preoperative comorbidities,and blood biochemical indexes.After excluding 86 patients according to the inclusion and exclusion criteria,480 patients were followed up by telephone.The follow-up included the patients’ current survival status,whether they had re-fracture,whether they took calcium tablets,whether they took vitamin D supplementation,whether they had bone density test,whether they had anti-osteoporosis treatment and the patients’ compliance with medication.Finally,402 patients were included in the study,in which patients who had re-fracture were the case group and patients who did not have re-fracture were the control group,and the relevant factors affecting re-fracture were compared and analyzed.SPSS 26.0 statistical software was used for data analysis,and statistical descriptions of categorical variables were expressed as frequencies and percentages;The measurement data conforming to normal distribution were expressed as mean ± standard deviation(x±s),and independent sample t-test was used between groups;For measures that did not conform to a normal distribution,the Manwhy-turney U test was used;Categorical variables were tested by chi-square test;variables with multiple factor interactions were analyzed by binary logistic regression;P<0.05 indicates that the difference is statistically significant.Result1.General information of patients and current status of osteoporosis diagnosis and treatment:402 patients were included in this study,135(33.58%)were male and 267(66.42%)were female,the minimum age of patients was 60 years old,the maximum age was 95 years old,the average age was(76.79±7.93)years old;84.33%of fractures were caused by falls,6.96%by weight-bearing on the low back,8.71%by other(change of position,sprain,no obvious cause).The rate of diagnosis of osteoporosis was 25.12%,the rate of bone density testing was 13.93%,the rate of taking anti-osteoporosis drugs was 9.45%,and the rate of good compliance with drug treatment was 14.29%.2.Comparison of the basic conditions of the two groups:the mean age of the case group was(79.70 ± 4.90)years,and the mean age of the control group was(76.57 ± 8.09)years,and the difference in age between the two groups was statistically significant(P<0.05);the mean BMI of the case group was(20.35 ± 1.15)kg/m2,and the mean BMI of the control group was(22.38 ± 10.04)kg/m2,and the difference in BMI between the two groups was statistically significant(P<0.01).The difference was statistically significant(P<0.01);the difference in gender between the two groups of patients was not statistically significant(P>0.05).3.Comparison of biochemical indexes between the two groups:the values of hemoglobin,serum albumin,total bilirubin and serum uric acid in the case group were significantly lower than those in the control group(P<0.05).Fasting blood glucose,TG and TC were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in alkaline phosphatase,blood creatinine,AST,ALT,HDL-c and LDL-c between the two groups(P>0.05).4.Comparison of comorbidities and Charlson scores between the two groups:a higher proportion of patients in the case group had comorbidities such as chronic obstructive pulmonary disease(COPD),Parkinson’s disease,diabetes mellitus,hyperlipidemia,and the difference was statistically significant between the two groups(P<0.05);hypertension,coronary artery disease,arrhythmia,heart failure,dementia,cerebrovascular disease,mild liver disease,connective tissue disease,and peptic ulcer and other comorbidities,there was no statistically significant comparison between the two groups(P<0.05).I In addition,the CCL score of the case group was significantly higher than that of the control group,and the difference between the two groups was statistically significant.(P<0.05).5.Multifactorial binary logistic regression analysis showed that age,BMI,COPD,diabetes,Parkinson’s,hyperlipidemia,serum albumin,TG,and TC were associated factors for the occurrence of re-fracture.Among them,age,COPD,diabetes,Parkinson’s disease,TG and TC are the risk factors for recurrent fracture.BMI and serum albumin are protective factors for recurrent fracture.Conclusion1.The diagnosis rate and treatment rate of osteoporosis in elderly hip fracture patients are low,and patients do not pay much attention to osteoporosis and comply with treatment.2.Old age,low BMI,COPD,diabetes,Parkinson’s disease,hyperlipidemia and biochemical indexes such as low serum albumin,high TC and high TG are the risk factors of recurrent hip fracture in elderly patients with hip fracture.3.CCL score has an effect on the occurrence of re-fracture in elderly hip fracture patients,which helps to predict the postoperative outcome and guide clinical treatment. |
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