■一项前瞻性队列研究的事后分析。
■这项研究旨在确定在骨质疏松性椎体骨折(OVFs)的慢性期中与日常生活活动(ADLs)下降相关的损伤时的因素。
■尽管保守方法是OVF的治疗选择,在某些情况下,ADL不会改善或最终减少。然而,OVF发生后ADL下降的危险因素,特别是那些有或没有初始卧床休息的人之间的区别,是未知的。
■共纳入224例年龄≥65岁的OVF患者,在损伤发生后2周内接受治疗。术后随访6个月。评估独立程度的标准用于评估ADL。采用Logistic回归模型进行多变量分析以评估ADL下降的危险因素。
■总共,49/224例患者(21.9%)表现为ADL下降。其中,其余组的23/116患者(19.8%)和无休息组的26/108患者(24.1%)的ADL下降。在逻辑回归分析中,T2加权磁共振成像(MRI)的弥漫性低信号(比值比,5.78;95%置信区间,2.09-16.0;p=0.0007)和椎骨不稳定性(赔率比,3.89;95%置信区间,1.32-11.4;p=0.0135)被确定为休息和无休息组的独立因素,分别。
■在急性OVFs患者中,在初次卧床和未卧床治疗的患者中,T2加权MRI的弥漫性低信号和严重的椎体不稳定与ADL下降独立相关。分别。
UNASSIGNED: A post-hoc analysis of a prospective cohort study.
UNASSIGNED: This study aimed to identify factors at the time of injury associated with declining activities of daily living (ADLs) in the chronic phase of osteoporotic vertebral fractures (OVFs) managed conservatively.
UNASSIGNED: Although a conservative approach is the treatment of choice for OVFs, ADLs do not improve or eventually decrease in some cases. However, the risk factors for ADL decline after the occurrence of OVFs, particularly the difference between those with or without initial bed rest, are unknown.
UNASSIGNED: A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline.
UNASSIGNED: In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2- weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09-16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32-11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively.
UNASSIGNED: In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively.