老年髋部骨折患者术后1年死亡的相关因素分析

Analysis of risk factors for death within 1 year after hip fracture surgery in the elderly

目的探讨老年髋部骨折患者术后1年死亡的影响因素。方法回顾性分析2014年1月至2022年12月在空军军医大学第一附属医院接受手术治疗且获得随访的1263例老年髋部骨折患者的临床资料,根据患者术后1年的生存情况,分为死亡组(212例)和存活组(1051例)。通过单因素及多因素Logistic回归模型分析与1年死亡率相关的因素。结果患者术后1年死亡率为16.78%,多因素Logistic回归分析结果显示,性别女性(OR=0.67,95%CI:0.48~0.95)、年龄(>85岁)(OR=2.23,95%CI:1.56~3.19)、体质指数(BMI)(<18.5)(OR=1.74,95%CI:1.17~2.60)、BMI(30~40)(OR=3.14,95%CI:1.20~8.21)、脑卒中(OR=1.59,95%CI:1.06~2.38)、贫血(OR=1.75,95%CI:1.07~2.86)、血浆纤维蛋白质(FIB)(<1.8或>3.5)(OR=1.63,95%CI:1.12~2.37)、深静脉血栓(OR=1.57,95%CI:1.13~2.18)、美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级(Ⅲ/Ⅳ)(OR=2.37,95%CI:1.56~3.59)是老年髋部骨折患者术后1年内死亡的重要预测因子。结论年龄>85岁、BMI(<18.5,30~40)、脑卒中、贫血、FIB(<1.8或>3.5)、深静脉血栓、ASA分级(Ⅲ/Ⅳ)为老年髋部骨折患者术后1年内死亡的独立危险因素,而女性性别是其保护性因素。

Objective To investigate the factors influencing mortality within one year following hip fracture surgery in elderly patients.Methods This study retrospectively analyzed clinical data from 1263 elderly patients with hip fractures who underwent surgery at the First Affiliated Hospital of Air Force Medical University between January 2014 and December 2022.Based on their survival status one-year post-surgery,the patients were categorized into two groups:the death group(212 cases)and the survival group(1051 cases).Univariate and multivariate logistic regression models were employed to identify factors associated with 1-year mortality.Results The 1-year mortality rate was found to be 16.78%.Multivariate logistic regression analysis identified several significant predictors of 1-year mortality in elderly patients with hip fractures.These predictors include gender(OR=0.67,95%CI:0.48-0.95),age greater than 85 years(OR=2.23,95%CI:1.56-3.19),body mass index(BMI)less than 18.5(OR=1.74,95%CI:1.17-2.60),BMI between 30 and 40(OR=3.14,95%CI:1.20-8.21),history of stroke(OR=1.59,95%CI:1.06-2.38),presence of anemia(OR=1.75,95%CI:1.07-2.86),fibrinogen(FIB)levels either below 1.8 or above 3.5(OR=1.63,95%CI:1.12-2.37),deep vein thrombosis(OR=1.57,95%CI:1.13-2.18),and American Society of Anesthesiologists(ASA)grade Ⅲ/Ⅳ(OR=2.37,95%CI:1.56-3.59).Conclusions In elderly patients with hip fractures,age over 85 years,a BMI less than 18.5 or between 30 and 40,the presence of stroke,anemia,FIB levels below 1.8 or above 3.5,deep vein thrombosis(DVT),and ASA classifications Ⅲ or Ⅳ are identified as independent risk factors for 1-year mortality.Conversely,being female serves as a protective factor.