Relationship between physical function at admission and walking ability at discharge in older adults with vertebral compression fractures: an analysis using propensity score matching.

Abstract

Background: Vertebral compression fractures (VCFs) are common among older adults, with the highest prevalence observed in Japan. These fractures cause pain, reduce quality of life, and increase the need for physical therapy. This study identified key factors at admission that predict walking ability at discharge in patients with VCFs.

Methods: This retrospective cohort study included 143 patients aged ≥65 years with VCFs. VCFs are fractures in which only the anterior column of the vertebral body collapses. The primary variables assessed upon admission included the revised Hasegawa Dementia Scale (HDS-R) score, grip strength, skeletal muscle mass index (SMI), and phase angle (PhA). Propensity score matching was applied to adjust for background factors, after which a logistic regression analysis using a generalized linear model was conducted to determine whether these variables influenced walking ability at discharge.

Results: Significant associations were observed between walking ability at discharge and HDS-R score at admission (p < 0.001, effect size [ES] = 0.42), grip strength (p = 0.027, ES = 0.23), SMI (p = 0.025, ES = 0.23), and PhA (p < 0.001, ES = 0.40). Logistic regression analysis indicated that HDS-R score (odds ratio [OR] = 1.19, p = 0.005) and PhA (OR = 3.21, p = 0.015) during admission significantly predicted walking ability at discharge.

Conclusion: Walking ability at discharge in patients with VCFs can be predicted based on early assessments. In particular, HDS-R score and PhA at admission may serve as key indicators for prognosis in patients with VCFs.