高龄股骨粗隆间骨折内固定手术患者住院时长影响因素的研究

Influencing factors of length of hospital stay in oldest-old patients undergoing internal fixation surgery for intertrochanteric fractures

目的对行内固定手术治疗的高龄股骨粗隆间骨折患者的病历资料进行回顾分析,以探讨可能影响患者住院时长的因素。方法采用整群抽样法,选取2016年1月—2020年12月在上海交通大学医学院附属第九人民医院骨科行手术内固定治疗的高龄(≥80岁)股骨粗隆间骨折患者为研究对象进行回顾性分析。收集患者的病历资料,记录患者的性别、年龄、术前等待时间、总住院时间以及术前血红蛋白水平、白蛋白水平、空腹血糖水平等指标,采用单因素分析、多重线性回归分析探讨股骨粗隆间骨折患者住院时间的影响因素。采用Spearman相关性分析探讨患者一般资料和临床各化验指标与总住院时长的相关性。结果最终选择122例高龄患者的病历资料纳入研究。在年龄方面,<85岁的患者总住院时间长与85~90岁和>90岁的患者比较,差异有统计学意义(P<0.05);在性别方面,女性患者的术前等待时间和住院总时间均长于男性患者,差异有统计学意义(P<0.05);入院时段不同的患者术前等待时间和总住院时长比较差异均无统计学意义(P>0.05)。相关分析结果显示,年龄、术前等待时间、术前血红蛋白与患者的总住院时长存在相关性(P<0.05)。多重线性回归分析结果显示,术前等待时间是患者总住院时长的影响因素(P<0.01)。结论高龄股骨粗隆间骨折患者的总住院时长与术前等待时间存在相关性,在准备充足的条件下应安排患者尽快手术,有助于患者尽早出院并开展康复功能锻炼。

Objective To retrospectively analyze medical records of oldest-old patients with femoral intertrochanteric fracture undergoing internal fixation surgical treatment,so as to explore factors that may affect the length of hospital stay.Methods Using the cluster sampling method,all oldest-old patients(≥80 years old)with femoral intertrochanteric fracture who underwent surgical internal fixation in Department of Orthopedics of Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2020 were selected for retrospective analysis.The medical records of patients were collected and the patient's gender,age,preoperative waiting time,total length of hospital stay,preoperative hemoglobin level,albumin level,fasting blood glucose level and other indicators were recorded.Univariate analysis and multiple linear regression were used to analyze the influencing factors of length of hospital stay in patients with intertrochanteric fractures.Spearman correlation analysis was used to explore the correlation between patients'general data,clinical laboratory indexes and the total length of hospital stay.Results Finally,the medical records of 122 oldest-old patients were included in the study.In terms of age,the postoperative hospitalization time of patients aged<85 was longer than that of patients aged 85 to 90 and over 90,and the difference was statistically significant(P<0.05).In terms of gender,the preoperative waiting time and total length of hospital stay of female patients were longer than those of male patients,and the differences were statistically significant(P<0.05).There was no statistically significant difference in preoperative waiting time and total length of hospital stay among patients with different admission dates(P>0.05).The results of correlation analysis showed that age,preoperative waiting time and preoperative hemoglobin were correlated with the total length of hospital stay(P<0.05).The results of multiple linear regression analysis showed that the preoperative waiting time was the influencing factor of the total length of hospital stay(P<0.01).Conclusions The total length of hospital stay in oldest-old patients with intertrochanteric fractures is correlated with the preoperative waiting time.Under the condition of adequate preparation,patients should be arranged for surgery as soon as possible,which is conducive to early discharge and rehabilitation exercise.