Purpose： The incidence of hip fractures is increasing within the aging population. Our objective was to identify and quantify the risk factors and develop a predictive model for the in-hospital mortality among hip fr...Purpose： The incidence of hip fractures is increasing within the aging population. Our objective was to identify and quantify the risk factors and develop a predictive model for the in-hospital mortality among hip fracture patients older than 65 years. Methods： This is a prospective study conducted on 331 hip fracture patients older than 65 years admitted to our hospital from 2011 to 2014. Patients＇ demographics, prehospitalization residential status, pre- fracture comorbidity data, anti-aggregant and anticoagulant medication, preoperative hemoglobin value, type of fractures, type of treatments, time to surgery, and complications were recorded. Results： The average age was 83 years, 73% female, and 57% of them sustained a femoral neck fracture. In 62.8% of patients, the number of pre-fracture baseline comorbidities was 〉2. The in-hospital mortality rate was 11.4%. In multivariate analysis, age over 90 years, congestive heart failure, asthma, rheumatologic disease, lung cancer, and not taking antiaggregant medication were independently associated with in-hospital mortality. A formula and risk stratification scoring for predicting the risk for in-hospital mortality was developed, Risk-adjustment model based on these variables had acceptable accuracy for predicting in-hospital mortality （c-statistic 0.77）. Conclusion： Advanced age, and five prefracture comorbidities have a strong association with in-hospital mortality in a hip fracture patient older than 65 years old. Our predictive model was specifically designed for the old hip fracture population. It has an accuracy similar to other risk models. The specificity, positive predictive value, and negative predictive value are high. In addition, it could discriminate a high risk patient from a low risk patient for in-hospital mortality.展开更多
目的:运用Rodgers演化概念分析法界定老年人虐待的概念。方法:系统检索中国知网、万方数据知识服务平台、PubMed、Web of Science、CINAHL,根据纳入标准选取42篇文献,应用Rodgers概念分析框架,从老年人虐待概念的演化、概念属性、先决...目的:运用Rodgers演化概念分析法界定老年人虐待的概念。方法:系统检索中国知网、万方数据知识服务平台、PubMed、Web of Science、CINAHL,根据纳入标准选取42篇文献,应用Rodgers概念分析框架,从老年人虐待概念的演化、概念属性、先决条件和影响因素、结局及相关概念等方面对老年人虐待的相关内容进行分析、整合。结果:老年人虐待包括身体虐待、精神虐待、经济虐待、性虐待、疏于照料、自我忽视、社会虐待7个概念属性;先决条件包括内在因素和外在因素;结局关注生活质量、身心健康状况、死亡率及卫生保健服务利用率。结论:老年人虐待概念尚未统一,目前,我国对老年人虐待的相关研究还不够全面、深入,今后应进一步对老年人虐待进行深层次、多方位探究。展开更多
文摘Purpose： The incidence of hip fractures is increasing within the aging population. Our objective was to identify and quantify the risk factors and develop a predictive model for the in-hospital mortality among hip fracture patients older than 65 years. Methods： This is a prospective study conducted on 331 hip fracture patients older than 65 years admitted to our hospital from 2011 to 2014. Patients＇ demographics, prehospitalization residential status, pre- fracture comorbidity data, anti-aggregant and anticoagulant medication, preoperative hemoglobin value, type of fractures, type of treatments, time to surgery, and complications were recorded. Results： The average age was 83 years, 73% female, and 57% of them sustained a femoral neck fracture. In 62.8% of patients, the number of pre-fracture baseline comorbidities was 〉2. The in-hospital mortality rate was 11.4%. In multivariate analysis, age over 90 years, congestive heart failure, asthma, rheumatologic disease, lung cancer, and not taking antiaggregant medication were independently associated with in-hospital mortality. A formula and risk stratification scoring for predicting the risk for in-hospital mortality was developed, Risk-adjustment model based on these variables had acceptable accuracy for predicting in-hospital mortality （c-statistic 0.77）. Conclusion： Advanced age, and five prefracture comorbidities have a strong association with in-hospital mortality in a hip fracture patient older than 65 years old. Our predictive model was specifically designed for the old hip fracture population. It has an accuracy similar to other risk models. The specificity, positive predictive value, and negative predictive value are high. In addition, it could discriminate a high risk patient from a low risk patient for in-hospital mortality.
文摘目的:运用Rodgers演化概念分析法界定老年人虐待的概念。方法:系统检索中国知网、万方数据知识服务平台、PubMed、Web of Science、CINAHL,根据纳入标准选取42篇文献,应用Rodgers概念分析框架,从老年人虐待概念的演化、概念属性、先决条件和影响因素、结局及相关概念等方面对老年人虐待的相关内容进行分析、整合。结果:老年人虐待包括身体虐待、精神虐待、经济虐待、性虐待、疏于照料、自我忽视、社会虐待7个概念属性;先决条件包括内在因素和外在因素;结局关注生活质量、身心健康状况、死亡率及卫生保健服务利用率。结论:老年人虐待概念尚未统一,目前,我国对老年人虐待的相关研究还不够全面、深入,今后应进一步对老年人虐待进行深层次、多方位探究。
