大于等于80岁的老年髋部骨折患者术后1年内死亡的独立危险因素

Risk factors for death within 1 year after surgery in elderly patients with hip fracture

目的探讨高龄(≥80岁)老年髋部骨折患者术后1年内死亡的危险因素。方法以2016~2019年204例经手术治疗的高龄髋部骨折患者作为研究对象,记录年龄、性别、术前合并疾病、骨折类型、麻醉方式、美国麻醉医师协会(ASA)评分、术前血红蛋白水平、术前白蛋白水平、术前血钙水平、住院时间等临床资料,以术后1年内死亡为观察结局。采用多因素logistic回归模型分析高龄老年髋部骨折患者术后1年内死亡的独立危险因素。结果术后1年内,共有82例患者术后死亡,死亡率为40.2%。性别、BMI、骨折类型、麻醉方式、术前血红蛋白水平、术前血钙水平及住院时间不影响80岁患者髋关节术后死亡率,差异无统计学意义(P>0.05);年龄、术前合并疾病数量、ASA评分以及术前白蛋白水平是高龄老年髋部骨折患者术后1年内死亡的独立危险因素(P<0.05)。结论年龄、术前合并疾病数量、ASA评分、术前白蛋白水平是高龄老年髋部骨折患者术后1年内死亡的独立危险因素。

Objective To explore the risk factors of death in elderly patients with hip fracture within 1 year after surgery.Methods A total of 204 elderly hip fractures patients who underwent surgery treatment from 2016 to 2019 were selected.The clinical data were retrospectively collected,including age,gender,preoperative comorbidities,fracture type,anesthesia method,American Society of Anesthesiologists(ASA)score,preoperative hemoglobin,preoperative albumin,preoperative serum calcium,length of hospital stay were recorded,and death within 1 year after operation as the clinical outcome.Multivariate logistic regression model was used to analyze the independent risk factors of death within 1 year after surgery.Results A total of 82 patients died within 1 year after surgery,with a mortality rate of 40.2%.Gender,BMI,fracture type,anesthesia methods,preoperative hemoglobin,preoperative serum calcium and length of hospital stay did not affect the postoperative mortality of the hip in 80-year-old patients,and the difference was not significant(P>0.05).Age,number of preoperative complications,ASA score,and preoperative albumin were the independent risk factors for death within 1 year after surgery in elderly patients with hip fracture.Conclusion The mortality rate of the elderly patients with hip fracture within 1 year after operation is relatively high.Age,preoperative comorbidities,ASA score,and preoperative albumin are the independent risk factors of 1-year mortality in elderly patients with hip fracture.