OBJECTIVE: To evaluate the effects of body mass index (BMI) on recovery of activities of daily living (ADL) in older Asian patients with femoral fracture registered in a nationwide inpatient database in Japan.
METHODS: We retrospectively analyzed data of patients aged >/=65 years with acute femoral fracture between April 2014 and November 2017 in the Diagnosis Procedure Combination database. Patients were classified into the following categories based on BMI (kg/m(2)): underweight (<18.5); normal weight (18.5-22.9); overweight (23-27.4); obese (>/=27.5); and missing data. Demographic data included age, sex, type of fracture, comorbidities, and Barthel Index (BI). The primary outcome was BI at discharge and secondary outcomes were the overall complication rate and discharge to home.
RESULTS: In total, data for 13,348 patients were extracted from the database, of whom 80.3 % were female. At discharge, underweight patients had lower BI than overweight or obese patients. In multivariable analysis, underweight and missing BMI data were associated with lower BI at discharge (partial regression coefficients -2.324 and -5.763, respectively). In contrast, overweight and obese were correlated with higher BI (3.080 and 5.732, respectively). Underweight was independently associated with a higher overall complication rate (odds ratio 1.195) and a lower rate of discharge to home (odds ratio 0.865).
CONCLUSIONS: Underweight was associated with poorer performance in ADL, higher risk of complications, and lower rate of discharge to home in older Asian patients with femoral fracture. Overweight and obese had positive effects on ADL.
|組織名||Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation;Hospital, 4-11 Gin-yamachi, Nagasaki City, Nagasaki, 850-0854, Japan; Department;of Clinical Nutrition and Food Management, Institute of Biomedical Sciences,;Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima City,;Tokushima, 770-8503, Japan. Electronic address: email@example.com.;Department of Rehabilitation Medicine, Yokohama City University Medical Center,;4-57 Urafune-chou, Minami-ku, Yokohama City, Kanagawa, 232-0024, Japan.;Electronic address: firstname.lastname@example.org.;Department of Palliative and Supportive Medicine, Graduate School of Medicine,;Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.;Electronic address: email@example.com.;Takano Hospital, 214 Higashimachi, Shimokitaba, Hironomachi, Futaba-gun,;Fukushima, 979-0402, Japan. Electronic address: firstname.lastname@example.org.;Department of Clinical Nutrition and Food Management, Institute of Biomedical;Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima;City, Tokushima, 770-8503, Japan. Electronic address: email@example.com.;Department of Health Sciences, Faculty of Human Culture and Science, Prefectural;University of Hiroshima, 1-1-71 Ujinahigashi, Minami-ku, Hiroshima City,;Hiroshima, 734-8558, Japan. Electronic address: firstname.lastname@example.org.;Department of Rehabilitation Medicine, Teikyo University School of Medicine;University Hospital, Mizonokuchi, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki City,;Kanagawa, 213-8507, Japan. Electronic address: email@example.com.|