摘要
目的 探讨围手术期因素对PFNA治疗老年转子间骨折术后1年死亡率的影响,并分析影响患者术后1年内死亡的独立危险因素.方法 回顾性分析2014年6月至2016年6月216例PFNA治疗的转子间骨折患者的临床资料.采用卡方检验选取有统计学意义的因素,并对有意义的因素进行多因素二分类Logistic回归分析,探索影响患者术后1年死亡的独立危险因素.结果 单因素分析结果显示:患者年龄,BMI,入院时HGB,入院中性粒细胞数、淋巴细胞数、肌酐,出院时HGB,是否输血,骨质疏松,是否有高血压、糖尿病、心脏病、脑梗死史等12个因素均影响到患者术后1年死亡率,差异有统计学意义(P<0.05).多因素分析结果显示影响患者术后1年死亡率的独立危险因素有BMI<18.5(OR=9.091,95%CI:3.279~25.204)、入院HGB<100g/L(OR=3.096,95%CI:1.319~7.269)、骨质疏松(OR=6.434,95%CI:2.618~15.814)、糖尿病(OR=4.872,95%CI:1.830~12.970)、心脏病(OR=6.146,95%CI:1.874~20.151)、脑梗死史(OR=3.237, 95%CI:1.117~9.380).结论 低BMI、入院时贫血状态、骨质疏松及内科基础疾病(糖尿病、心脏病、脑梗死史)是影响术后1年死亡的独立危险因素.对于基础状态较好的患者建议早期手术,全身情况较差的患者术前予以积极干预并早期手术.
Objective To investigate the affection of peri-operation factor on aged patients intertrochanteric fracture treated with PFNA on 1-year mortality,and analyze the independent risk factor of 1-year mortality. Method Retrospective analyzing 216 intertrochanteric fracture patients who treated with PFNA in author's hospital from June 2014 to June 2016. Chi-square test was used to find out significant factors which were then analyzed by multifactor dichotomy logistic regression analysis to investigate independent risk factors. Results Single factor analysis results showed that age,BMI,admission HGB,admission WBC,admission lymphocyte,admission Cr,HGB at leaving hospital,blood transfusion,osteoporosis, hypertension,diabetes,cardiopathy,cerebral infarction had significant influence on post-operation 1-year mortality(P<0.05). Multifactor dichotomy logistic regression analysis results showed that BMI<18.5(OR=9.091,95%CI:3.279~25.204),admission HGB<100g/L(OR=3.096, 95%CI:1.319~7.269),osteoporosis(OR=6.434,95%CI:2.618~15.814),diabetes(OR=4.872,95%CI:1.830~12.970),cardiopathy (OR=6.146,95%CI:1.874~20.151),cerebral infarction(OR=3.237,95%CI:1.117~9.380)were the independent risk factor of 1-year mortality(P<0.05). Conclusions The low BMI level,anemia at admission,osteoporosis,medical disease(diabetes,cardiopathy,cerebral infarction)are independent risk factor of 1-year mortality. Patients free from medical disease should get operation as soon as possible,patients with poor systemic condition should get internal medicine before operation.
出处
《浙江临床医学》
2019年第3期313-315,共3页
Zhejiang Clinical Medical Journal
