Osteoporos Sarcopenia.  2022 Dec;8(4):152-157. 10.1016/j.afos.2022.11.001.

Lower SMI is a risk factor for dysphagia in Japanese hospitalized patients with osteoporotic vertebral and hip fracture: A retrospective study

Affiliations
  • 1Department of Spine Surgery, Yokohama General Hospital, 2201-5, Kurogane-cho, Aoba-ku, Yokohama, Kanagawa, 225-0025, Japan
  • 2Department of Orthopaedic Surgery, Yokohama General Hospital, 2201-5, Kurogane-cho, Aoba-ku, Yokohama, Kanagawa, 225-0025, Japan
  • 3Department of Orthopaedic Surgery, Funabashi Central Hospital, 6-13-10, Kaijin, Funabashi, Chiba, 273-8556, Japan
  • 4Department of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 228-8555, Japan

Abstract


Objectives
Many patients with osteoporotic fragile fracture often suffer from dysphagia that results in malnutrition, further deterioration of physical strength, and rehabilitation difficulties. This study aims to investigate the risk factors for dysphagia in hospitalized patients with osteoporotic vertebral and/or hip fractures.
Methods
Between January 2020 and December 2021, 569 inpatients were managed for osteoporotic vertebral or hip fractures. Of these, 503 patients were analyzed and 66 were excluded as the required data could not be obtained or dysphagia with causative diseases such as cerebrovascular disease. The patients were divided into 2 groups: patients with dysphagia (P-group) and patients without dysphagia (N-group). We investigated gender, fracture site, age, systemic skeletal muscle mass index (SMI), bone mineral density (BMD), and body mass index (BMI) in early stage of hospitalization and studied their relationship with dysphagia.
Results
There were no significant differences in gender and fracture site between the 2 groups. A significant difference was observed in age, SMI, BMD, and BMI (P < 0.01). We performed a logistic regression analysis with the P-group as the objective variable and age, SMI, BMD, and BMI as explanatory variables. We divided objective groups into all patients, patients with vertebral fracture, patients with hip fracture, men, and women. SMI was an independent risk factor in all groups.
Conclusions
Lower SMI was a risk factor for dysphagia in hospitalized patients with osteoporotic vertebral and hip fractures. We carefully observed swallowing function of patients with decreased SMI to maintain the nutritional status and prevent rehabilitation difficulties.

Keyword

Osteoporotic vertebral fracture; Osteoporotic hip fracture; Dysphagia; Systemic skeletal muscle mass index; Sarcopenia
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