髋部骨折高龄患者术后死亡的相关因素回顾性分析

Retrospective analysis of relevant factors of death in postoperative elderly patients with hip fracture

[目的]探讨髋部骨折高龄患者手术疗效以及术后死亡的相关危险因素。[方法]选取髋部骨折高龄患者196例,随访记录患者临床资料,分析术后1年死亡率及其主要死因,应用logistic回归模型分析相关性。[结果]术后1年内有35例患者死亡,死亡率为17.86%,分析相关因素,年龄(P=0.024)、性别(P=0.031)、术前内科合并症(P=0.013)和ASA分级(P=0.000)与高死亡率具有相关性,差异均具有统计学意义(P<0.05),骨折类型、骨折部位、麻醉方式和手术方式与高死亡率无明显相关性(P>0.05);Logistic回归分析表明年龄、性别、术前内科合并症和ASA分级是其独立危险因素,差异均具有统计学意义(P<0.05)。[结论]年龄、性别、术前内科合并症和ASA分级是髋部骨折高龄患者术后1年内高死亡率的独立危险因素。

[Objective] To study the effect of the surgery in elderly patients with hip fracture and the risk factors of postoperative death.[Method]One- hundred and nighty six patients with hip fracture were selected. The main causes of mortality 1year after surgery and correlation were analyzed using logistic regression model.[Result]Thirty- five patients died 1 year after surgery,and the mortality rate was 17. 86%. The factors,age（ P = 0. 024）,gender（ P = 0. 031）,preoperative medical complications（ P = 0. 013） and ASA classification（ P = 0. 000） were correlated with high mortality rates. The differences were statistically significant（ P〈0. 05）. Type of fracture,the fracture site,anesthesia and surgical procedures showed no significant correlation with the high mortality rate（ P〉0. 05）. The Logistic regression analysis showed that age,gender,preoperative medical comorbidities,and ASA classification were the independent risk factors. The differences were statistically significant（ P〈0. 05）.[Conclusion]The factors including age,gender,preoperative medical comorbidities and ASA classification are independent risk factors of high mortality for elderly patients with hip fracture within 1 year after operation.