老年股骨粗隆间骨折髓内钉治疗术后1年死亡风险及危险因素分析

Analysis of Mortality and Risk Factors One Year after the Treatment of the Aged Intertrochanteric Fracture of Femur Intramullary Nailing

目的分析老年股骨粗隆间骨折髓内钉治疗术后1年死亡风险和危险因素。方法分析2018年12月至2020年12月宁夏医科大学总医院收治的108例老年股骨粗隆间骨折髓内钉治疗患者的临床资料,根据患者术后1年生存状态将其分为存活组(n=88)与死亡组(n=20),并进行单因素分析及多因素Logistic回归分析。结果本研究108例患者中共有20例(18.52%)患者1年内死亡。单因素分析显示:两组患者年龄、手术时间、ASA分级、术前合并症数量、术前血红蛋白含量、术前白蛋白含量、术后并发症数量比较差异均有统计学意义(P均<0.05),而性别、受伤至手术的时间、术中出血量比较差异均无统计学意义(P均>0.05)。多因素Logistic回归分析显示:年龄(OR=1.151)、术后并发症数量(OR=1.786)是老年股骨粗隆间骨折髓内钉治疗术后1年病死率的影响因素(P均<0.05)。结论高龄、术后并发症多的患者股骨粗隆间骨折髓内钉治疗术后1年内发生早期死亡的风险更高。

Objective To analyze the mortality and risk factors at 1 year after the treatment of the aged intertrochanteric fracture of femur intramullary nailing.Methods The clinical data of 108 patients treated with intramedullary nailing for elderly intertrochanteric fracture in General Hospital of Ningxia Medical University from December 2018 to December 2020 were analyzed.The patients were divided into survival group(n=88)and death group(n=20)according to their survival state one year after surgery,and univariate analysis and multivariate logistic regression analysis were performed.Results Among the 108 patients in this study,20 patients(18.52%)died within 1 year.Univariate analysis showed statistically significant(P all<0.05)differences in age,the operation time,ASA grade,preoperative complications,preoperative hemoglobin content,preoperative albumin content and postoperative complications between the two groups,while there were no statistically significant(P all>0.05)differences in gender,time from injury to surgery and intraoperative blood loss between the two groups.Multivariate logistic regression analysis showed that age(OR=1.151)and the number of postoperative complications(OR=1.786)were influencing factors affecting the one year mortality after intramedullary nailing for elderly intertrochanteric fractures(P all<0.05).Conclusion The elderly patients treated with intramedullary nailing for intertrochanteric fracture and postoperative complications play an important role in increasing the one-year postoperative mortality.