术前C反应蛋白水平同老年股骨颈骨折患者的术后并发症相关

Preoperative C-reactive protein level has a dose-response relationship with postoperative complications in elderly patients with femoral neck fracture

目的分析术前C反应蛋白水平同老年股骨颈骨折患者术后并发症的相关性。方法回顾分析147名老年股骨颈骨折患者(年龄中位数:80岁,女性:73.5%),根据术前CRP水平将患者分为正常组(CRP<10 mg/L)31名,轻度升高组(10 mg/L≤CRP<40 mg/L)51名,严重升高组(CRP≥40 mg/L)65名。比较不同CRP水平同术后并发症的相关性。结果术前CRP水平同术后并发症存在相关性(P=0.003)。同正常组相比,轻度升高组和严重升高组的校正前OR值分别为0.97(0.29,3.27),3.04(1.03,8.98);校正后OR值分别为1.13(0.33,3.90),4.89(1.47,16.26)。结论术前CRP水平同老年股骨颈骨折患者关节置换术后发生并发症风险呈剂量反应关系。当术前CRP≥40 mg/L时,老年股骨颈骨折患者关节置换术后发生并发症的风险是正常组的4.89倍(P=0.003)。

Objective To analyze the association of preoperative C-reactive protein(CRP) level with postoperative complications in elderly patients undergoing surgeries for femoral neck fracture. Methods We retrospectively analyzed the data of 147 elderly patients(median age 80 years;73.5% of the patients were female) undergoing surgeries for femoral neck fracture.According to preoperative CRP level, the patients were divided into normal CRP(<10 mg/L) group(31 patients), mild elevation group(CRP level of 10-40 mg/L;51 patients), and severe elevation group(CRP≥40 mg/L;65 patients). The association of preoperative CRP levels with postoperative complications was analyzed. Results Preoperative CRP level was significantly correlated with the occurrence of postoperative complications(P=0.003). Compared with that in normal CRP group, the unadjusted ORs in mild and severe elevation groups were 0.97(95%CI: 0.29-3.27) and 3.04(95%CI: 1.03-8.98) with the adjusted ORs of 1.13(95%CI: 0.33-3.90) and 4.89(95%CI: 1.47-16.26), respectively. Conclusion Preoperative CRP level has a dose-response relationship with complications in elderly patients following arthroplasty for femoral neck fracture, and the patients with a preoperative CRP level≥40 mg/L are exposed to a significantly increased risk for postoperative complications by 3.89 folds compared with the patients with a normal CRP level.