| 术前等待时间对老年髋部骨折患者预后的影响 |
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投稿时间：2020-02-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 王志聪 |
WANG Zhi-cong |
德阳市骨科中心 德阳市人民医院骨科, 四川 德阳 618000 |
Orthopaedic Centre of Deyang City
Department of Orthopaedics,People's Hospital of Deyang City,Deyang 618000,Sichuan,China |
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| 陈曦 |
CHEN Xi |
德阳市骨科中心 德阳市人民医院骨科, 四川 德阳 618000 |
Orthopaedic Centre of Deyang City
Department of Orthopaedics,People's Hospital of Deyang City,Deyang 618000,Sichuan,China |
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| 吴俞萱 |
WU Yu-xuan |
德阳市骨科中心 德阳市人民医院骨科, 四川 德阳 618000 |
Orthopaedic Centre of Deyang City
Department of Orthopaedics,People's Hospital of Deyang City,Deyang 618000,Sichuan,China |
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| 杨灵 |
YANG Ling |
德阳市骨科中心 德阳市人民医院骨科, 四川 德阳 618000 |
Orthopaedic Centre of Deyang City
Department of Orthopaedics,People's Hospital of Deyang City,Deyang 618000,Sichuan,China |
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| 汪红 |
WANG Hong |
德阳市骨科中心 德阳市人民医院骨科, 四川 德阳 618000 |
Orthopaedic Centre of Deyang City
Department of Orthopaedics,People's Hospital of Deyang City,Deyang 618000,Sichuan,China |
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| 江伟 |
JIANG Wei |
德阳市骨科中心 德阳市人民医院骨科, 四川 德阳 618000 |
Orthopaedic Centre of Deyang City
Department of Orthopaedics,People's Hospital of Deyang City,Deyang 618000,Sichuan,China |
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| 高博 |
GAO Bo |
德阳市骨科中心 德阳市人民医院骨科, 四川 德阳 618000 |
Orthopaedic Centre of Deyang City
Department of Orthopaedics,People's Hospital of Deyang City,Deyang 618000,Sichuan,China |
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| 刘跃洪 |
and LIU Yue-hong |
德阳市骨科中心 德阳市人民医院骨科, 四川 德阳 618000 |
Orthopaedic Centre of Deyang City
Department of Orthopaedics,People's Hospital of Deyang City,Deyang 618000,Sichuan,China |
doctorliuyuehong@163.com |
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| 期刊信息：《中国骨伤》2022年，第35卷，第4期，第361-366页 |
| DOI：10.12200/j.issn.1003-0034.2022.04.013 |
| 基金项目:2019年德阳市科技计划项目(编号:2019SZ125) |
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中文摘要:
目的: 探讨术前等待时间与老年髋部骨折患者预后的关系。
方法: 回顾分析2014年1月至2018年12月行手术治疗的333例老年髋部骨折患者,其中男104例,女229例;年龄60~99(77.93±8.49)岁;股骨颈骨折183例,股骨转子间骨折150例;269例(80.78%)患者术前等待时间2~8 d,根据术前等待时间分为<4 d组(91例)和 ≥ 4 d组(242例)。电话随访患者生存情况,随访时间为骨折入院至患者死亡,或至研究截止日期(2019年12月31日)。采用Kaplan-Meier法进行生存分析,Cox风险比例模型分析影响老年髋部骨折预后的独立危险因素。
结果: 333例老年髋部骨折患者随访12~75个月,平均35个月,59例患者死亡,病死率为17.72%(59/333),其中 ≥ 4 d死亡50例,病死率20.66%(50/242)明显高于4 d内死亡(9.89%,9/91)(χ2=5.263,P=0.022)。多因素Cox回归分析显示术前等待时间,年龄,男性和Charlson合并症指数(Charlson comorbidity index,CCI)是老年髋部骨折预后的独立危险因素(均P<0.05);其中每延迟1 d手术,老年髋部骨折患者的死亡风险增加5%[HR=1.05,95%CI(1.00-1.10),P=0.045]。按CCI指数分层分析,术前等待时间 ≥ 4 d组在CCI<2分患者群中病死率更高,差异有统计学意义(P<0.05)。
结论: 针对老年髋部骨折患者,即使大部分医院暂时无法在48 h内实施手术,也应该努力缩短术前等待时间,从而改善其预后。 |
| 【关键词】老年人 髋骨折 预后 |
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| Effect of preoperative waiting time on prognosis of elderly patients with hip fracture |
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ABSTRACT
Objective: To investigate the relationship between preoperative waiting time and prognosis of elderly patients with hip fracture.
Methods: From January 2014 to December 2018,333 elderly hip fracture patients undergoing surgery were retrospectively analyzed,including 104 males and 229 females,aged from 60 to 99 years with an average of (77.93±8.49) years,and 183 patients were femoral neck fracture,150 patients were femoral intertrochanteric fracture. Among them,269 patients (80.78%) had a clustered preoperative waiting time of 2 to 8 days,and then divided into within 4-day group(91 cases) and over 4-day group(242 cases) according to their preoperative waiting time. The survival situation was followed by telephone,and follow-up time started from fracture admission to the death event,or to the research deadline (December 31,2019). The Kaplan-Meier method was used for survival analysis,and Cox risk proportion model was used to analyze the independent risk factors of hip fracture in elderly patients.
Results: All patients were followed up for 12 to 75 months(means 35 months),59 patients died and the mortality rate was 17.72%(59/333). Compared with within 4-day group,the mortality rate was higher in over 4-day group[20.66%(50/242) vs. 9.89%(9/91),χ2=5.263,P=0.022]. Multiariable Cox regression analysis showed that preoperative waiting time,age,male and Charlson comorbidity index were independent risk factors for the prognosis of hip fracture in elderly patients (all P<0.05),and every 1-day delay was associated with 5% increase of the risk of death[HR=1.05,95%CI(1.00-1.10),P=0.045]. Subsequent analyse was stratified according to the Charlson comorbidity index (CCI),and found that over 4-day group had a higher mortality rate in patients with CCI<2,with statistically significant difference(P<0.05).
Conclusion: For elderly patients with hip fracture,most of hospitals could not complete the hip fracture surgery within 48 hours,we also need to shorten the waiting time before surgery,and thereby improve their prognosis. |
| KEY WORDS Aged Hip fractures Prognosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王志聪,陈曦,吴俞萱,杨灵,汪红,江伟,高博,刘跃洪.术前等待时间对老年髋部骨折患者预后的影响[J].中国骨伤,2022,35(4):361~366 |
| 英文格式: | WANG Zhi-cong,CHEN Xi,WU Yu-xuan,YANG Ling,WANG Hong,JIANG Wei,GAO Bo,and LIU Yue-hong.Effect of preoperative waiting time on prognosis of elderly patients with hip fracture[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(4):361~366 |
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