老年髋部骨折手术时机及住院时间的相关因素研究

Analysis of factors influencing the operative timing and hospitalization time on hip fracture in the elderly

[目的]对影响老年髋部骨折手术患者手术时机及住院天数相关因素进行统计学分析,得出显著相关因素,制定患者的治疗和康复计划。[方法]选择2010年5月～2012年4月手术治疗的髋部骨折患者159例,根据手术时机分为早期手术组和晚期手术组,把年龄,性别,是否周末时间入院,居住情况,骨折前活动能力,骨折前行走能力,骨折前日常生活能力,骨折类型,健康状况,并存病数量为自变量,手术时间为应变量,建立多元回归模型,对影响手术时机的相关因素分析。同时将麻醉方式,手术方式,手术出血量,手术时间,术后是否出现并发症等为自变量,术后住院时间为应变量,建立多元回归方程,进行相关因素分析。[结果]符合入选标准者早期手术组65例,晚期手术组94例。logitic回归分析后发现是否周末时间入院对手术时机影响最大。患者术后有无并发症对住院时间影响最大。[结论]老年髋部骨折手术时机要因人制宜,健康状况好,手术意愿强及非周末时间住院的患者是早期手术重要因素,而住院时间与并发症有相关性,且早期手术患者住院时间短。

[ Objective] To study the factors influencing the operative timing and hospitalization time on hip fracture in the elderly by statistic analysis, and to obtain significant relative factors and make treatment and rehabilitation plan. [ Method ] One hundred and fifty - nine patients with hip fracture were treated from May 2010 to April 2012. The patients who had an operation within two days were classified into the early surgery group. And other patients who had an operation more than two days were classified into the later surgery group. The difference among two groups was compared. Age, gender, admission in the weekend, living situation, activities of daily living before fracture, fracture type, physical condition, comorbidity, independent variable and operative timing dependent variable were made respectively, and to do linear corrdation analysis setting up Logistic regression models. The factors that influence the operative timing were analyzed. Meanwhile, anesthesia methods, type of intervention, bleed- ing volume, operating time, complication, independent variable and hospitalization time dependent variable were made respective- ly, and to do linear correlation analysis building Logistic regression models. [ Result ] One hundred and fifty - nine patients were included in the study. There were 65 cases in the early surgery group, while there were 94 patients in the late surgery group. Ad- mission in the weekend had significant effect on operative timing. Meanwhile, complication had most important effect on hospital- ization time. [ Conclusion] The operative timing of hip fracture in the elderly should be chosen according to the variability of dif- ferent patient. The important facts on early surgical treatment of hip fractures are good health, strong willing to operation and ad- mission not in the weekend. Complication is assoociated with hospitalization time and patients in early surgery group experienced shorter length of hospital stay.