老年髋部骨折患者合并骨折的临床特征及其危险因素分析

Clinical features and risk factors of the hip fracture accompanied with other fractures in the elderly

[目的]回顾性分析老年髋部骨折患者合并骨折的临床特征及其危险因素。[方法]通过电子病历系统收集2005年1月~2014年12月本院诊治的老年髋部骨折患者的临床资料,共1 289例纳入本研究。记录包括年龄、性别、合并内科疾病情况、骨折类型和是否合并其他部位骨折等,行描述性统计分析,采用单因素和多因素分析寻找老年髋部骨折患者合并骨折的危险因素。[结果] 1 289例老年髋部骨折患者中合并骨折者107例,占8.30%。尺桡骨、肱骨和胸腰椎体是老年髋部骨折常见合并骨折部位。女性、股骨颈骨折、合并高血压和神经系统疾病的老年患者合并骨折比例显著高于其他患者(P<0.05)。逻辑回归分析结果显示,高龄(OR=1.306,P<0.05)、女性(OR=2.255,P<0.05)、股骨颈骨折(OR=2.146,P<0.05)和伴有高血压(OR=2.197,P<0.05)是老年髋部骨折患者合并骨折的显著危险因素。[结论]老年髋部骨折患者常合并其他部位骨折,常见的骨折部位为尺桡骨、肱骨和胸腰椎体。老龄、女性、骨折类型和合并高血压是老年髋部骨折患者合并骨折的危险因素。

[Objective] To explore the clinical characteristics and risk factors of the hip fracture accompanied with other fractures in the elderly. [Methods] The clinical data was retrieved form electronic medical records of the patients who admitted to Zhongda Hospital Affiliated to Southeast University from January 2005 to December 2014 for hip fracture. A total of 1 289 patients who met the including criteria were enrolled into this study. The data, including age, gender, comorbidity of internal diseases, fracture entity and whether or not accompanied with other fractures were assessed by the descriptive analysis. In addition,the risk factors were searched by univariate and multivariant analysis. [Results] Of the 1 289 patients with hip fracture, 107 patients were accompanied with other fractures, accounted for 8.30%. The common sites of combined fractures were ulna and radius, humerus and thoracolumbar vertebra. Compared with those without other fractures, the patients accompanied with other fractures were significantly dominated by advanced age, female, femoral neck fracture, combined hypertension and neurological diseases(P<0.05). In addition, the multiple binary logistic regression analysis revealed that the advanced age(OR=1.306, P<0.05), female(OR=2.255, P<0.05), femoral neck fracture(OR=2.146, P<0.05) and accompanied hypertension(OR=2.197, P<0.05) were the significant risk factors for combined fractures in the elderly with hip fracture. [Conclusion] The elderly patients with hip fracture are often accompanied with other fractures. Ulna and radius, humerus and thoracolumbar vertebra are the common sites of the combined fractures. Advanced age, female, femoral neck fracture and hypertension are the significant risk factors for the combined fractures.