老年髋部骨折术后预后不良的影响因素及对策

Influencing Factors and Countermeasures of Poor Prognosis of Elderly Hip Fractures after Surgery

目的:分析老年髋部骨折术后预后不良的影响因素及相关对策。方法:回顾性分析2015年1月-2018年1月本院收治1 352例老年髋部骨折患者临床资料,术后随访至2019年6月。记录患者预后不良(严重并发症或病死)情况及患者基线资料,包括性别、年龄、骨折类型、合并内科疾病、手术时机、手术方式、住院时间,经单因素与多因素分析,研究老年髋部骨折术后预后不良的影响因素。结果:1 352例患者预后不良243例,占17.97%。单因素、多因素Logistic回归分析结果显示,年龄>70岁、合并内科疾病≥3种、手术时机≥72 h、住院时间≥15 d是老年髋部骨折术后预后不良的影响因素(OR>1,P<0.05)。结论:年龄较大,合并内科疾病较多、手术时机≥72 h、住院时间≥15 d是老年髋部骨折术后预后不良的影响因素,积极治疗基础疾病,尽早进行手术可一定程度上改善患者的预后。

Objective:To analyze the influencing factors and related countermeasures of poor prognosis of elderly hip fractures after surgery.Method:The clinical data of 1 352 elderly hip fracture patients treated in our hospital from January 2015 to January 2018 were retrospectively analyzed.All were followed up to June 2019 after surgery.The patients’ poor prognosis (severe complications or death) and the patients’ baseline information were recorded,included gender,age,fracture type,complicated medical diseases,operation timing,operation method,and length of hospital stay.Through single factor and multiple factors analysis,the influencing factors of the poor prognosis of elderly hip fractures were studied.Result:A total of 243 cases of 1 352 patients had a poor prognosis,accounting for 17.97%.The results of single factor and multiple Logistic regression analysis showed that age >70 years old,complicated medical diseases ≥3 kinds,and operation time ≥72 h,length of hospital stay ≥15 d were the influencing factors for the poor prognosis of elderly hip fractures after surgery (OR>1,P<0.05).Conclusion:Age >70 years old,complicated medical diseases ≥3 kinds,and operation time ≥72 h,length of hospital stay ≥15 d were the influencing factors for the poor prognosis of elderly hip fractures after surgery.Active treatment of underlying diseases and early surgery can improve the prognosis of patients to a certain extent.