摘要
目的研究老年髋部骨折术后1年死亡率及其影响因素。方法回顾性研究2012年10月至2013年6月我院收治的髋部骨折患者的资料,通过电话随访患者的健康状态,分析术后1年死亡率,通过病历总结分析年龄、性别、骨折类型、伤前健康状态、活动能力、合并症、手术时机、手术类型、麻醉方式和术后并发症等资料,并对相关影响因素进行单因素及多因素回归分析。结果共收集资料完整患者184例,随访12-23个月,平均16.5个月,1年累计死亡30例,死亡率为16.3%。单因素分析显示,年龄、性别、骨折类型、合并疾病数量、合并有慢性阻塞性肺疾病或脑卒中后遗症、ASA评分、麻醉方式、伤前活动能力、术后并发症等因素在存活组与死亡组间差异有统计学意义（P〈0.05）。多因素回归分析显示,年龄、合并疾病数量、伤前活动能力及合并慢性阻塞性肺疾病是影响死亡的独立危险因素。结论在治疗老年髋部骨折时应充分考虑到影响中长期死亡的危险因素,选择适当的麻醉及治疗方式,改善术前健康状况,将有助于减低术后的死亡率、提高手术疗效。
Objective To explore the factors influencing one year survival after hip fracture surgery in elderly population. Methods Records from patients undergoing surgery for hip fracture at our hospital from October 2012 to June2013 were retrospectively reviewed. By telephone follow- up, the health condition of each patient was surveyed, and the one year postoperative mortality was analyzed. The patients＇ age, gender, fracture type, pre-injury health condition, mobility, complications, surgical time, surgical types, methods of anesthesia and postoperative complications were analyzed.Univariate and multivariate regression analysis was performed on relevant influencing factors. Results A total of 184 patients had complete data and was followed-up for 12-23 months（average 16.5 months）. There were 30 deaths（16.3%） at one year. Univariate analysis revealed that factors such as age, gender, fracture type, number of co-existing diseases, complications such as chronic obstructive pulmonary disease or sequelae of stroke, ASA scores, anesthesia methods, pre-injury activity, and post-operative complications were significantly different between survival and death groups（P〈0.05）. Multivariate regression analysis revealed that age, co- existing disease number, pre- injury mobility and combined chronic obstructive pulmonary disease were independent risk factors for death. Conclusion Full consider of medium-/long- term risk factors in the treatment of hip fracture in the elderly, select appropriate anesthesia and treatment methods, and improved pre-surgical health conditions may reduce postoperative mortality and enhance surgical efficacy.
出处
《北京医学》
CAS
2015年第11期1031-1035,共5页
Beijing Medical Journal
基金
首都临床特色应用研究(Z141107002514024)
首都卫生发展科研专项(首发2011-5021-03)
