Relationship between low basal metabolic rate and mortality in older adults with hip fractures

Transcription

1 Chinese Journal of Tissue Engineering Research ( ) DOI: /j.issn ORCID: () 1 30 d ( 2 h ) :R318 :A Logistic %(68/507) (P < 0.05)Logistic 1 1 (2016M T10048)(QNRC ) Relationship between low basal metabolic rate and mortality in older adults with hip fractures Sun Chun-sheng, Zheng Xin, Guo Kai-jin, Li Dong-ya, Li Cheng-yu, Wang Yi, Chang Bu-qing, Feng Shuo, Li Hong-wei (Department of Orthopedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou , Jiangsu Province, China) Abstract BACKGROUND: Basal metabolic rate (BMR) is an important indicator of human energy metabolism, and low BMR leads to the dysfunction of liver and kidney. Low BMR is usually found in patients with hip fractures, but there is a lack of study on the relationship between mortality of hip fracture and low BMR. OBJECTIVE: To investigate the effect of low BMR on the 1-year mortality in older adults with hip fractures. METHODS: Totally 507 patients with hip fractures aged more than 60 years from January 2014 to March Sun Chun-sheng, Master candidate, Department of Orthopedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou , Jiangsu Province, China Corresponding author: Li Hong-wei, M.D., Chief physician, Master s supervisor, Department of Orthopedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou , Jiangsu Province, China : (2018)

2 . [J] (16): DOI: /j.issn were included in this retrospective study. Age, sex, surgery or not, surgical pathway, duration from injury to surgery, hospitalized pulmonary infection, number and kind of comorbidities, and 1-year mortality were recorded. BMR on admission was recorded, and multiple Logistic regression analysis was applied. RESULTS AND CONCLUSION: All patients were followed up for 1315 months, and the 1-year mortality was 13.41% (68/507). The mortality in the low BMR group was significantly higher than that in the non-low BMR group (P < 0.05). Logistic regression analysis showed that older age, conventional treatment, number of combined medical diseases, hospitalized pulmonary infection, and low BMR are risk factors for 1-year mortality in older adults with hip fracture. These results imply that low BMR is strongly associated with 1-year mortality in older adults with hip fracture. BMR can reflect the nutritional status, neuroendocrine, cellular and energy metabolism. Thereafter, for older adults with hip fractures and low BMI, nutrition therapy, re-warming, and endocrine therapy may help reduce the trauma-induced mortality. Subject headings: Tissue Engineering; Fractures, Bone; Mortality; Basal Metabolism Funding: the Postdoctoral Science Foundation of China, No. 2016M and 2017T10048; the Youth Medical Talents Project of Jiangsu Province, No. QNRC Introduction [1] % [2] [3] 112%37% [4] 13.5 [5] [6] Subjects and methods [7] (< ) <12(6320 ) (77.3±8.2) (PFNA) =(+ )111±10%±15% 20%<20% ( min) () x _ ±s SPSS 16.0(IBM) ()t 8 Logisticα 2468 ISSN CN /R CODEN: ZLKHAH

3 Sun CS, Zheng X, Guo KJ, Li DY, Li CY, Wang Y, Chang BQ, Feng S, Li HW. Relationship between low basal metabolic rate and mortality in older adults with hip fractures. Zhongguo Zuzhi Gongcheng Yanjiu. 2018;22(16): DOI: /j.issn P < Results (1)<60 13 (2) 3 (3) 22 (4) 28 (5) <12 1 Figure 1 Trial flow chart %(30/507) %(68/507) 26.61% 9.14%1(P < 0.051) 1 Table 1 Baseline data of patients with or without low basal metabolic rate <20% 20% P (n) _ (x ±s) 77.0± ± (%) (n) (n) (n) (n) (n) (n) (n) (%) (n) _ (x ±sd) 9.1± ± (n) (12)Logistic 1 (23) 3Discussion [8-9] [810-11] Kannegaard [8] 1Wu [12] 1 Karademir [13] Ersin [14] Vidal [15] 1 1 [ ] 3 [16] Jürisson [18] Chatterton [10] Chatterton 1 13% P.O. Box 10002, Shenyang

4 . [J] (16): DOI: /j.issn () Table 2 Multiple Logistic regression analysis of 1-year mortality in patients with hip fracture Β 2 P OR 95%CI () (2) () Table 3 Multiple Logistic regression analysis of 1-year mortality in patients with hip fracture undergoing surgery β 2 P OR 95%CI () () (2) [19] [20] Faizi [21] < d [22-24] [25] [26] [23] ( ) [27] [28] 70% [29] Galusova [30] ICU1 (TSH)T4FT420% T333%FT3 7FT4 [31] min 2470 ISSN CN /R CODEN: ZLKHAH

5 Sun CS, Zheng X, Guo KJ, Li DY, Li CY, Wang Y, Chang BQ, Feng S, Li HW. Relationship between low basal metabolic rate and mortality in older adults with hip fractures. Zhongguo Zuzhi Gongcheng Yanjiu. 2018;22(16): DOI: /j.issn (2016M T10048)(QNRC ) (STROBE ) CNKI 3 () References [1] Cooper C, Cole ZA, Holroyd CR, et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. 2011;22(5):1277. [2] Xia WB, He SL, Xu L, et al. Rapidly increasing rates of hip fracture in Beijing, China. J Bone Miner Res. 2012;27(1): [3] Torpilliesi T, Bellelli G, Morghen S, et al. Outcomes of nonagenarian patients after rehabilitation following hip fracture surgery. J Am Med Dir Assoc. 2012;13(1):1-5. [4] Kayatas K, Sahin G, Tepe M, et al. Acute kidney injury in the elderly hospitalized patients. Ren Fail. 2014;36(8): [5] Lystad RP, Cameron CM, Mitchell RJ. Mortality risk among older Australians hospitalised with hip fracture: a population-based matched cohort study. Arch Osteoporos. 2017;12(1):67. [6],,,. [J].,2014,34(7): [7].[J]., 2008,14(10): [8] Kannegaard PN, Van dms, Eiken P, et al. Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age Ageing. 2010; 39(2):203. [9] Carretta E, Bochicchio V, Rucci P, et al. Hip fracture: effectiveness of early surgery to prevent 30-day mortality. Int Orthop.2011;35(3): [10] Chatterton BD, Moores TS, Ahmad S, et al. Cause of death and factors associated with early in-hospital mortality after hip fracture. Bone Joint J. 2015;97-B(2):246. [11] Cha YH, Ha YC, Yoo JI, et al. Effect of causes of surgical delay on early and late mortality in patients with proximal hip fracture. Arch Orthop Trauma Surg. 2017;137(5): [12] Wu LC, Chou MY, Liang CK, et al. Factors affecting one-year mortality of elderly patients after surgery for hip fracture. Int J Gerontol. 2016;10(4): [13] Karademir G, Bilgin Y, Erşen A, et al. Hip fractures in patients older than 75 years old: Retrospective analysis for prognostic factors. Int J Surg. 2015;24(Pt A): [14] Ercin E, Bilgili MG, Sari C, et al. Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients. Eur J Orthop Surg Traumatol. 2016:1-6. [15] Vidal E, Moreira-Filho D, Pinheiro R, et al. Delay from fracture to hospital admission: a new risk factor for hip fracture mortality? Osteoporos Int. 2012;23(12): [16] Roche JJW. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005;331(7529): [17] Hong SE, Kim TY, Yoo JH, et al. Acute kidney injury can predict in-hospital and long-term mortality in elderly patients undergoing hip fracture surgery. PLoS One. 2017;12(4):e [18] Jürisson M, Raag M, Kallikorm R, et al. The impact of comorbidities on hip fracture mortality: a retrospective population-based cohort study. Arch Osteoporos. 2017;12(1):76. [19] Tsuei BJ, Kearney PA. Hypothermia in the trauma patient. Injury. 2004;35(1):7-15. [20] Moffatt SE. Hypothermia in trauma. Emerg Med J. 2013;30(12): [21] Faizi M, Farrier AJ, Venkatesan M, et al. Is body temperature an independent predictor of mortality in hip fracture patients? Injury. 2014;45(12): [22] Murphy MC, Brooks CN, New SA, et al. The use of the Mini-Nutritional Assessment (MNA) tool in elderly orthopaedic patients. Eur J Clin Nutr. 2000;54(7):555. [23] Li HJ, Cheng HS, Liang J, et al. Functional recovery of older people with hip fracture: does malnutrition make a difference? J Adv Nurs. 2013;69(8): [24] Korenhakim T, Weiss A, Hershkovitz A, et al. The relationship between nutritional status of hip fracture operated elderly patients and their functioning, comorbidity and outcome. Clin Nutr. 2012; 31(6): [25] Carlsson P, Tidermark J, Ponzer S, et al. Food habits and appetite of elderly women at the time of a femoral neck fracture and after nutritional and anabolic support. J Hum Nutr Diet. 2005;18(2): 117. [26] Inzitari M, Doets E, Bartali B, et al. Nutrition in the age-related disablement process. J Nutr Health Aging. 2011;15(8): [27] Engelking LR. Chapter 75-Starvation (The Intermediate Phase). Textbook of Veterinary Physiological Chemistry. 2015: [28] Larsen PR, Davies TF, Schlumberger MJ, et al. Thyroid physiology and diagnostic evaluation of patients with thyroid disorders [29] Docter R, Krenning EP, Jong MD, et al. The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism. Clin Endocrinol (Oxf). 2010;39(5): [30] Galusova A, Pauliny M, Majek M, et al. Dynamic neuroendocrine changes in critically ill patients with polytrauma. Neuro Endocrinol Lett. 2015;36(5): [31] Greenspan L, Mclellan BA, Greig H. Abbreviated Injury Scale and Injury Severity Score: a scoring chart. J Trauma. 1985;25(1): P.O. Box 10002, Shenyang