摘要
目的分析预后营养指数(prognostic nutritional index,PNI)对老年骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者术后近期预后的影响。方法选取2018年8月~2020年12月在本院行PKP手术的老年OVCF患者83例,随访观察6个月,根据患者是否发生不良预后分为不良预后组(n=15)和预后良好组(n=68)。同时根据患者PNI绘制ROC曲线,取PNI为39.5为截断值,将患者分为高PNI组(n=19)和低PNI组(n=64)。观察所有患者术后3个月、6个月的椎体前缘压缩高度、后凸Cobb角、ODI指数、疼痛VAS评分,探究老年OVCF术后近期不良预后的危险因素,同时对比不同PNI患者术后的临床效果。结果PKP术后随访期间发生疼痛、骨水泥渗漏、再次骨折等不良预后的发生率为18.1%(15/83)。单因素分析发现,骨密度、白蛋白、前白蛋白、PNI与老年OVCF术后近期不良预后相关(P<0.05);多因素分析发现低骨密度、低PNI是老年OVCF术后不良预后的危险因素(P<0.05)。高PNI组患者术后3个月、6个月的VAS评分、ODI指数、椎体前缘压缩高度比、Cobb角均优于低PNI组,差异有统计学意义(P<0.05)。结论PNI可作为老年OVCF患者术后近期预后的预测指标,值得临床关注。
Objective To analyze the effect of prognostic nutritional index(PNI)on the short-term prognosis of elderly patients with osteoporotic vertebral compression fracture(OVCF)after surgery.Methods From August 2018 to December 2020,83 elderly patients with OVCF who underwent percutaneous kyphoplasty(PKP)in our hospital were selected.The patients were followed up for 6 months,and the patients were divided into poor prognosis group(n=15)and good prognosis group(n=68)according to whether they had a poor prognosis.The ROC curve was drawn according to the patients’PNI,and the PNI 39.5 was as the cutoff value.The patients were divided into a high PNI group(n=19)and a low PNI group(n=64).At 3 and 6 months after surgery,the compression height of the anterior edge of the vertebral body,Cobb angle of kyphosis,ODI index,and pain VAS scores were observed to explore the risk factors of the short-term poor prognosis after OVCF operation in elderly patients,and the clinical effects of different PNI patients after OVCF operation were compared.Results During the follow-up period after PKP,the incidence rate of adverse prognosis such as pain,bone cement leakage and refracture was 18.1%(15/83).Univariate analysis found that bone density,albumin,prealbumin and PNI were related to the short-term poor prognosis after OVCF in the elderly.Multivariate analysis found that low bone mineral density and low PNI were risk factors for the poor prognosis of elderly OVCF.At 3 months and 6 months after surgery,the VAS,ODI,vertebral compression height ratio,and Cobb angle in the high PNI group were better than those in the low PNI group,the differences were statistically significant(P<0.05).Conclusion PNI can be used as a predictor of short-term prognosis after OVCF in the elderly,and it is worthy of clinical attention.
作者
钱三祥
薛刚
路友群
李家华
QIAN San-xiang;XUE Gang;LU You-qun;LI Jia-hua(Department of Orthopedics,Hefei BOE Hospital,Hefei,Anhui 230000,China)
出处
《颈腰痛杂志》
2022年第2期229-232,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
预后营养指数
老年
骨质疏松
压缩性骨折
预后
prognostic nutritional index
old age
osteoporosis
compression fracture
prognosis
