老年股骨远端骨折手术患者住院死亡率的预测因素:一项病例对照研究

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2023-01-01 Epub Date: 2023-12-07 DOI:10.1051/sicotj/2023035
Ting-An Cheng, Po-Hsuan Lai, Hao-Chun Chuang, Kai-Lan Hsu, Fa-Chuan Kuan, Wei-Ren Su, Chih-Kai Hong
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引用次数: 0

摘要

老年骨折包括股骨远端和髋部骨折与高死亡率相关。目前,院内术后死亡率的预后因素尚未确定。我们的目的是评估接受股骨远端骨折手术的老年患者的总体住院死亡率和相关的潜在危险因素。材料和方法:对2003年1月1日至2021年12月31日期间接受股骨远端骨折手术的60岁以上患者进行回顾性队列研究。采用病例对照研究,以1:4的比例比较两组年龄相当的老年患者。计算住院死亡率,并比较各组间潜在混杂因素。结果:共入组170例患者;手术后住院死亡5例,住院死亡率2.94%。20例未死亡的患者作为对照组。患者的人口统计数据相似。病例对照比较显示,损伤至手术时间、术前血红蛋白水平、估计肾小球滤过率(eGFR)和白细胞计数是院内死亡率的显著相关因素。讨论:住院总死亡率为2.94%。住院死亡率的重要危险因素包括从受伤到手术的时间较长,术前血红蛋白水平和eGFR较低,术前白细胞计数较高。综上所述,在老年骨折护理模式中,还应考虑术前综合老年评估,包括认知、营养和虚弱状态。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of in-hospital mortality in older patients undergoing distal femur fracture surgery: A case-control study.

Introduction: Geriatric fractures including distal femur and hip fractures are associated with high mortality rates. Currently, prognostic factors for in-hospital postoperative mortality are not identified. We aimed to evaluate overall in-hospital mortality and related potential risk factors in elderly patients who underwent distal femur fracture surgery.

Materials and methods: A retrospective cohort study of patients older than 60 years, who underwent distal femur fracture surgery between January 01, 2003, and December 31, 2021, was conducted. A case-control study was conducted to compare two age-matched groups of elderly patients of equivalent ages at a 1:4 ratio. The in-hospital mortality rate was calculated and potential confounders were compared between groups.

Results: A total of 170 patients were enrolled; five died during hospital stay after undergoing surgery, yielding a 2.94% in-hospital mortality rate. Twenty patients who did not die were included in the control group. Patients' demographics were similar. The case-control comparison showed that the time from injury to surgery, preoperative hemoglobin level, estimated glomerular filtration rate (eGFR), and white blood cell count were significant factors correlated with in-hospital mortality.

Discussion: The overall in-hospital mortality rate was 2.94%. Significant risk factors for in-hospital mortality included a longer time from injury to surgery, lower preoperative hemoglobin level and eGFR, and higher preoperative white blood cell count. In conclusion, preoperative comprehensive geriatric assessment, including cognitive, nutritional, and frailty status, should also be considered in the elderly fracture care model.

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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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