Analysis of related factors for sarco-osteoporosis in middle-aged and elderly inpatients and development and validation of a nomogram.

BACKGROUND: Sarco-osteoporosis is a skeletal muscle disease associated with aging and complex pathological factors. At present, there are few studies on the analysis of its related factors, and a nomogram to estimate the risk of sarco-osteoporosis in middle-aged and elderly patients is not available. METHODS: A total of 386 patients admitted to our hospital from October 2021 to October 2022 were collected, and the general demographic data and clinical data of the patients were collected.386 subjects were enrolled in the study and randomly divided into training set and validation set at a ratio of 7:3. In the training set, the Least absolute shrinkage and selection operator(LASSO)regression technique was used to select the optimal predictive features, and multivariate logistic regression was used to screen the factors associated with sarco-osteoporosis, and a nomogram was constructed using meaningful variables from multivariate analysis. The performance of the nomograms was assessed and validated by Area Under Curve (AUC) and calibration curves. RESULTS: There were no significant differences in baseline characteristic of individuals in training set and validation set, six variables with non-zero coefficients were screened based on LASSO regression in the training set. Multivariate logistic regression analysis showed that the related factors for sarco-osteoporosis in middle-aged and elderly inpatients included age (OR = 1.08, 95%CI 1.03 ∼ 1.14), regular exercise (OR = 0.29, 95%CI 0.15 ∼ 0.56), albumin (OR = 0.9, 95%CI 0.82 ∼ 0.98), height (OR = 0.93, 95%CI 0.88 ∼ 0.99) and lean mass index (OR = 0.66, 95%CI 0.52 ∼ 0.85), and a nomogram was constructed based on the above factors. AUC of nomogram were 0.868(95%CI 0.825 ∼ 0.912) in the training set and 0.737(95%CI 0.646 ∼ 0.828) in the validation set. Calibration curve analysis showed that the predicted probability of sarco-osteoporosis had high consistency with the actual probability, and the absolute error of the training set and verification set was 0.018 and 0.03, respectively. CONCLUSIONS: Our research showed that the occurrence of sarco-osteoporosis was associated with age, regular exercise, albumin, height and lean mass index, and we have developed a nomogram that can be effectively used in the preliminary and in-depth risk prediction of sarco-osteoporosis in middle-aged and elderly hospitalized patients.

Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis.

Background: Frailty is a syndrome of multisystem dysfunction in the elderly. The association between preoperative frailty and postoperative outcomes in patients with hip fractures is unclear. To address this issue, we performed a meta-analysis to determine the association of frailty with postoperative mortality, complications, and readmission in patients with hip fractures. Methods: We searched PubMed, Web of Science, Embase, and The Cochrane Library for cohort studies of frailty associated with postoperative adverse events in patients with hip fractures from inception to November 6, 2021. The Newcastle-Ottawa Scale was used to evaluate the quality of the included literature. Statistical analysis of meta-analysis was performed using Review Manager 5.3. Results: Twelve retrospective cohort studies and seven prospective cohort studies involving a total of 62,132 patients met the inclusion criteria for this meta-analysis. Compared with non-frail patients, the pooled results showed that frailty was associated with patient in-hospital mortality (relative risk [RR] = 2.93; 95% confidence intervals [CI]: 2.56-3.34), 30-day mortality (RR = 2.85, 95%CI: 1.67-4.85) and total complications (RR = 1.79, 95%CI: 1.50-2.15). Subgroup analysis showed that the type of study design and frailty assessment tool had no significant effect on the results. Sensitivity analysis showed that the polled results of frailty predicted one-year mortality and 30-day readmission was unstable. Conclusions: In this meta-analysis, we found that preoperative frailty may be associated with postoperative adverse events in patients with hip fractures, including in-hospital mortality, 30-day mortality, and postoperative complications.Systematic Review Registration: PROSPERO, identifier: CRD42021287739.

Local Spinal Cord Decompression Through a Full Endoscopic Percutaneous Transcorporeal Approach for Cervicothoracic Ossification of the Posterior Longitudinal Ligament at the T1-T2 Level.

OBJECTIVE: To describe a percutaneous full endoscopic transcorporeal procedure to excise local ossification of the posterior longitudinal ligament (OPLL) lesions and decompress the spinal cord at the cervicothoracic transitional segment is safe and effective with respect to surgical complications. METHODS: A 67-year-old woman presented with nuchal pain and numbness below the T2 dermatome for 3 months and a 2-week history of paraplegia. T1-T2 myelopathy and paraplegia caused by OPLL was diagnosed based on clinical presentation, computed tomography, and magnetic resonance imaging. An anterior percutaneous full endoscopic transcorporeal procedure addressed local OPLL and achieved local spinal cord decompression at T1-T2. After surgery, magnetic resonance imaging was repeated to evaluate degree of spinal cord decompression. Visual analog scale, Neck Disability Index, and Japanese Orthopaedic Association scores were evaluated at each follow-up. RESULTS: The patient tolerated the full endoscopic operation successfully. Operative time was 225 minutes. On postoperative day 6, muscle strength of the bilateral lower extremities had progressed from grade 0/5 preoperatively to grade 2-/5 on the right and grade 2+/5 on the left. No surgery-related complications were discovered. CONCLUSIONS: The percutaneous full endoscopic transcorporeal procedure is an alternative to previously described surgical methods of local spinal cord decompression for T1-T2 OPLL with fewer complications, effective spinal cord decompression, and a satisfactory cosmetic result. Successful cases confirm that treatment of spinal cord-limited compression by endoscopic technology is feasible.