Preoperative Indicators for 1-year Mortality in Elderly Individuals Following Hip Fracture Surgery Under A Multidisciplinary Team Co-Management Model: A Single-Centre Retrospective Observational Study.

IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY
Geriatric Orthopaedic Surgery & Rehabilitation Pub Date : 2025-06-25 eCollection Date: 2025-01-01 DOI:10.1177/21514593251356135
Yucheng Gao, Shaoyang Zhou, Wang Gao, Yuanwei Zhang, Liu Shi, Tian Xie, Chuwei Tian, Hui Chen, Yunfeng Rui
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引用次数: 0

Abstract

Background: Elderly patients have an impaired functional state and multiple comorbidities, resulting in poor postoperative rehabilitation ability and high rates of disability and mortality. However, little evidence exists on mortality predictors for geriatric hip fractures within the context of the multidisciplinary team co-management model. This study aimed to investigate the incidence and explore preoperative indicators of 1-year mortality following hip fractures in the elderly under this model.

Methods: A total of 439 elderly patients (130 men and 309 women) surgically treated for hip fractures under the multidisciplinary team co-management model between January 2018 and June 2021were included. Data regarding demographics, health state-related variables, injury- and admission-related variables, and preoperative laboratory test results were collected from medical records. Univariate and multivariate logistic regression analyses were used to identify preoperative indicators for 1-year mortality.

Results: A total of 49 patients died within 1 year of hip fracture surgery between January 2018 and June 2021, with an accumulated mortality rate of 11.16%. In univariate analysis, 14 items were found to be significant. In the multivariable logistic regression model, age >85 years, body mass index <21.0 kg/m2, time from injury to admission >9.5 h, preoperative haemoglobin <117 g/L, serum albumin <33.9 g/L, lactate dehydrogenase >292 U/L, and blood urea nitrogen >8.5 mmol/L were the independent preoperative indicators for 1-year mortality after surgery in elderly patients with hip fracture under the multidisciplinary team co-management model.

Conclusions: This study establishes a novel set of preoperative predictors for 1-year mortality in geriatric hip fracture patients managed under an MDT model, distinct from previous investigations focusing on postoperative interventions. The identified indicators enable early risk stratification, facilitating timely preoperative optimization. These findings underscore the prognostic value of integrating clinical and biochemical markers before surgery, warranting validation in multicenter prospective studies. Further prospective studies should be conducted to elucidate these associations and assess the effectiveness of targeted measures.

多学科团队共同管理模式下老年人髋部骨折术后1年死亡率的术前指标:一项单中心回顾性观察研究
背景:老年患者功能状态受损,并发多种合并症,术后康复能力差,致残率和死亡率高。然而,在多学科团队共同管理模式的背景下,几乎没有证据表明老年髋部骨折的死亡率预测因子。本研究旨在探讨该模型下老年人髋部骨折后1年死亡率的发生率和术前指标。方法:纳入2018年1月至2021年6月在多学科团队共同管理模式下接受髋部骨折手术治疗的老年患者439例(男性130例,女性309例)。从医疗记录中收集有关人口统计学、健康状态相关变量、损伤和入院相关变量以及术前实验室检查结果的数据。采用单因素和多因素logistic回归分析确定术前1年死亡率指标。结果:2018年1月至2021年6月髋部骨折术后1年内死亡49例,累计死亡率11.16%。在单变量分析中,发现14项显著。在多变量logistic回归模型中,年龄bbbb85岁、体重指数2、损伤至入院时间>9.5 h、术前血红蛋白292 U/L、血尿素氮>8.5 mmol/L是多学科团队协同管理模式下老年髋部骨折患者术后1年死亡率的独立术前指标。结论:本研究建立了一套新的MDT模式下老年髋部骨折患者1年死亡率的术前预测指标,不同于以往侧重于术后干预的研究。确定的指标可以早期进行风险分层,及时进行术前优化。这些发现强调了在手术前整合临床和生化指标的预后价值,值得在多中心前瞻性研究中验证。应该进行进一步的前瞻性研究来阐明这些关联并评估针对性措施的有效性。
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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
80
审稿时长
9 weeks
期刊介绍: Geriatric Orthopaedic Surgery & Rehabilitation (GOS) is an open access, peer-reviewed journal that provides clinical information concerning musculoskeletal conditions affecting the aging population. GOS focuses on care of geriatric orthopaedic patients and their subsequent rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE).
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