老年脆性骨折患者日常生活能力影响因素分析OA

Objective To observe the status of daily living ability in elderly patients with fragility fracture in the fifth year after fracture,and to analyze the influencing factors.Methods A retrospective analysis was conducted on 775 elderly patients with fragility fractures admitted to the Orthopedics Department of the Second Affiliated Hospital of Dalian Medical University from 2015 to 2016.Among 425 cases surviving within 5 years,functional status was assessed using both the Basic Activities of Daily Living(BADL)scale and the Instrumental Activities of Daily Living(IADL)scale.Evaluate and record patients over the phone,and use a multiple logistic regression model to analyze the factors affecting ADL and IADL in elderly patients with fragility fractures at 5 years af-ter fracture.Results Among 634 elderly patients with fragility fractures followed for 5 years,103(16.25%)experienced recurrent fractures,209(32.97%)died,and 41(9.65%)of the 425 surviving patients became disabled.The rate of BADL assistance needed at the 5th year post-fracture was 73.41%(312/425),with the highest requirements in descending order:ascending/descending stairs,bathing,mobility,bed-to-chair transfer,dressing,grooming,eating,toileting,and controlling bowel/bladder movements.The assistance requirement rate for Instrumental Activities of Daily Living(IADL)was 73.88%(314/425).The activities requiring assis-tance,in descending order of frequency,were:using transportation,shopping,doing housework,cooking,managing finances,laun-dry,taking medications,and using the telephone.Comparing pre-fracture levels,the required assistance rates for each BADL and IADL item increased compared to pre-fracture levels 5 years later.Logistic analysis was conducted on relevant factors,and it was found that age and cerebrovascular disease were common risk factors for BADL and IADL(P<0.05).The pre-fracture BADL and IADL scores had a certain promoting effect on the recovery of BADL and IADL(P<0.05),while there were no significant differences in gender,first fracture site,drug treatment,and re-fracture(P>0.05).Conclusion Age and cerebrovascular disease are risk factors for BADL and IADL,The pre-fracture BADL and IADL scores have a certain promoting effect on the recovery of BADL and IADL.