Nutritional status assessment and prognostic value in elderly patients with intertrochanteric femur fractures undergoing PFNA internal fixation
Objective This study aimed to explore the nutritional status assessment and prognostic value in elderly patients with intertrochanteric femur fractures undergoing PFNA(proximal femoral nail antirotation)internal fixation.Methods 86 elderly patients with intertrochanteric fractures treated with PFNA internal fixation from 2020 to 2022 in our hospital were selected for prognosis observation.A retrospective study was conducted to collect clinical data,assess nutritional risk and deficiency,comprehensively evaluate the decrease in food intake in the past week before surgery,and assess infectious complications.The adverse prognosis of elderly patients was also recorded.Single-factor analysis was performed on the survival group and the death group,and risk factors were analyzed.The predictive value of NRS 2002(numerical rating scale 2002)was evaluated.Results In the three age groups of 60～69 years,70～79 years and≥80 years,the proportion of patients at nutritional risk is 9.30%(8/86),18.60%(16/86)and 45.34%(39/86)respectively.Among them,≥80 years old group has the highest proportion of patients at nutritional risk,reaching 90.70%(39/43).At the same time,the older the age,the more patients at nutritional risk tend to increase.,respectively.Higher nutritional risk was closely related to the occurrence of infectious complications and prolonged hospital stays(P<0.05).Prognosis statistics for elderly patients showed that 9 patients died,accounting for 20.93%.Single-factor analysis showed that in the death group,age,APACHEⅡscore,NRS 2002 score,and MLR were significantly higher than in the survival group(P<0.05),and the incidence of coronary heart disease was also slightly higher than in the survival group(P<0.05).The NRS 2002 score and MLR had good predictive value for adverse prognosis.The AUC of the NRS 2002 score and MLR were 0.801 and 0.816,respectively,with high sensitivity and specificity.In addition,when these two indicators were combined together,their predictive value was further improved,with an AUC of 0.915.Conclusion Elderly patients with intertrochanteric fractures treated with PFNA internal fixation commonly have malnutrition after surgery.Age,disease severity,nutritional risk,and inflammation are closely associated with adverse prognosis.Clinicians should fully consider patients'age,health status,and nutritional status,adopt personalized treatment and rehabilitation measures to improve prognosis and quality of survival.At the same time,NRS 2002 scores and MLR have good predictive value in predicting death in elderly patients with intertrochanteric fractures treated with PFNA internal fixation.The combined application of these two indicators can more accurately assess patients'prognosis risks.
Intertrochanteric femur fracturesElderlyPFNA internal fixationNutritional status assessmentPrognosis
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