摘要
背景:迄今为止,关于髋部骨折术后死亡率的研究主要集中在术后30 d至1年及更长时间,但是鲜有关于髋部骨折术后早期死亡率的相关研究。目的:通过比较术后72 h内存活患者与死亡患者的组间差异,探究与髋部骨折患者术后72 h内死亡率相关的危险因素。方法:回顾分析2013年1月至2018年12月南方医科大学珠江医院收治的2811例髋部骨折患者的临床资料,包括手术治疗和保守治疗,患者年龄15-101岁,比较术后72 h内存活组患者和死亡组患者的组间差异。按照结局将患者分为存活组和死亡组,收集患者的病历资料,包括患者性别、年龄、术前ASA分级、受伤前行走能力评分、术前认知水平、是否口服抗凝药、骨折分型、手术方式、内植物种类、手术时间、输血量、麻醉方式、术后并发症等信息。各观察因素诊断以病历临床诊断为标准,记录患者术后72 h内患者的生存状态、死亡原因、术中及术后出现的并发症,并于术后半年内通过电话随访。结果与结论:①47例患者行保守治疗,1例患者入院后24 h死亡,共有2764例患者纳入研究;②患者平均年龄为72.5岁,包括2035例女性和729例男性,患者术后72 h内的死亡率为0.90%(25例);③在术后前72 h内的死亡组患者中,高龄、ASA 3级及以上、伤前行走能力受限以及认知障碍患者比例更高,差异有显著性意义(P<0.05);④在术后前72 h内存活组中有更多的患者在伤后48 h内接受手术治疗,差异有显著性意义(P<0.05);⑤死亡组患者的植入物相关并发症发生率更高,但是2组间差异无显著性意义(P>0.05);⑥提示对于髋部骨折患者手术管理的优化及其对生存的伴随影响已经得到了极大的关注,此次研究发现,髋部骨折术后72 h内死亡风险增加与高龄、ASA 3级及以上、伤前行走能力受限、认知障碍及伤后超过48 h接受手术治疗有关,但与患者的植入物种类无关。此次研究�
BACKGROUND:Up to now,the research on the mortality rate of hip fracture after operation mainly focuses on 30 days to 1 year and longer.However,there are few studies on early postoperative mortality of hip fracture.OBJECTIVE:To compare the differences between survived and dead patients at 72 hours after surgery,and to explore the risk factors associated with 72-hour postoperative mortality in hip fracture patients.METHODS:Clinical data of 2811 hip fracture patients admitted to Zhujiang Hospital of Southern Medical University from January 2013 to December 2018 were retrospectively analyzed,including surgical treatment and conservative treatment.The patient’s age ranged from 15 to 101 years old.This study compared the differences between the survival group and death group within 72 hours after surgery.According to the outcome,the patients were divided into survival group and death group.The patient’s medical records were collected,including gender,age,preoperative ASA classification,preoperative walking ability score,preoperative cognitive level,whether to take anticoagulants orally,fracture classification,operation mode,internal plant species,operation time,blood transfusion volume,anesthesia mode,and postoperative complications.The diagnosis of each observation factor was based on the clinical diagnosis of medical records.The survival status,cause of death,intraoperative and postoperative complications were recorded within 72 hours after operation.The patients were followed up by telephone within half a year after operation.RESULTS AND CONCLUSION:(1)Forty-seven patients received conservative treatment,and 1 patient died 24 hours after admission;totally 2764 patients were included in the study.(2)The average age was 72.5 years,including 2035 females and 729 males.The mortality rate within 72 hours after operation was about 0.90%(25 patients).(3)In the 72-hour postoperatively death group,the proportion of patients with advanced age,ASA grade 3 or above,pre-traumatic walking ability limitation and cognitive impai
作者
皮颖
田京
Pi Ying;Tian Jing(Department of Orthopedic Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510282,Guangdong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第12期1835-1840,共6页
Chinese Journal of Tissue Engineering Research
关键词
髋部骨折
死亡率
术后早期死亡率
围术期
危险因素
hip fracture
mortality
early postoperative mortality
perioperative period
risk factor
