高龄髋部骨折行人工髋关节置换术后患者再入院危险因素分析
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作者Author单位AddressE-Mail
张婷 ZHANG Ting 空军军医大学西京医院骨科, 陕西 西安 710000 Department of Orthopaedics, Xijing Hospital of Air Force Military Medical University, Xi'an 710000, Shaanxi, China  
赵轶男 ZHAO Yi-nan 空军军医大学西京医院骨科, 陕西 西安 710000 Department of Orthopaedics, Xijing Hospital of Air Force Military Medical University, Xi'an 710000, Shaanxi, China 10643754@qq.com 
牛志霞 NIU Zhi-xia 空军军医大学西京医院骨科, 陕西 西安 710000 Department of Orthopaedics, Xijing Hospital of Air Force Military Medical University, Xi'an 710000, Shaanxi, China  
全伟 QUAN Wei 空军军医大学西京医院骨科, 陕西 西安 710000 Department of Orthopaedics, Xijing Hospital of Air Force Military Medical University, Xi'an 710000, Shaanxi, China  
张慧 ZHANG Hui 空军军医大学西京医院骨科, 陕西 西安 710000 Department of Orthopaedics, Xijing Hospital of Air Force Military Medical University, Xi'an 710000, Shaanxi, China  
李志全 LI Zhi-quan 空军军医大学西京医院骨科, 陕西 西安 710000 Department of Orthopaedics, Xijing Hospital of Air Force Military Medical University, Xi'an 710000, Shaanxi, China  
刘艳武 LIU Yan-wu 空军军医大学西京医院骨科, 陕西 西安 710000 Department of Orthopaedics, Xijing Hospital of Air Force Military Medical University, Xi'an 710000, Shaanxi, China  
期刊信息:《中国骨伤》2022年,第35卷,第5期,第460-463页
DOI:10.12200/j.issn.1003-0034.2022.05.010
基金项目:
中文摘要:

目的:探讨高龄髋部骨折行人工髋关节置换术后患者再入院的发生率及危险因素分析。

方法:回顾性分析2015年2月至2020年10月接受人工髋关节置换的高龄髋部骨折患者237例,根据患者术后3个月再入院情况分为两组,其中再入院组39例,男7例,女32例,年龄(84.59±4.34)岁;未再入院组198例,男34例,女164例,年龄(84.65±4.17)岁。将两组患者的一般资料、手术情况、髋关节Harris评分和并发症纳入单因素分析,并采用多因素Logistic回归分析患者再入院的独立危险因素。

结果:再入院组中合并症(脑梗死和冠心病)的比例明显高于未再入院组(P<0.05),再入院组中术中出血量明显高于未再入院组(P<0.05),髋关节Harris评分明显低于未再入院组(P<0.05)。在并发症方面,再入院组发生感染、谵妄、关节脱位、贫血和静脉血栓形成的比例明显高于未再入院组(P<0.05)。多因素Logistic回归分析显示,高龄髋部骨折行人工髋关节置换术后患者再入院危险因素包括脑梗死、感染、谵妄、关节脱位、贫血和静脉血栓形成(P<0.05)。

结论:高龄髋部骨折行人工髋关节置换术后再入院的患者并发症明显高于未再入院患者,脑梗死、感染、谵妄、关节脱位、贫血和静脉血栓形成是导致患者再入院的危险因素,临床可根据这些危险因素采取相应的干预措施,以此减低患者再入院的发生率。
【关键词】老年人    骨折  髋关节置换  再入院  危险因素
 
Analysis of risk factors for readmission in elderly patients with hip fractures undergoing hip hemiarthroplasty
ABSTRACT  

Objective: To explore the incidence and risk factors of readmission of elderly patients with hip fracture after hip hemiarthroplasty.

Methods: A retrospective analysis of 237 elderly hip fracture patients who underwent hip hemiarthroplasty from February 2015 to October 2020 were performed. According to the readmission status of the patients at 3 months postoperatively,the patients were divided into readmission group (39 cases)and non-readmission group(198 cases). In readmission group,there were 7 males and 32 females with an average age of(84.59±4.34) years old,respectively,there were 34 males and 164 females with average age of (84.65±4.17) years old in non-readmission group. The general information,surgical status,hip Harris score and complications of patients in two groups were included in univariate analysis,and multivariate Logistic regression was used to analyze independent risk factors of patients' readmission.

Results: The proportion of complications(cerebral infarction and coronary heart disease) in readmission group was significantly higher than that of non-readmission group (P<0.05),and intraoperative blood loss in readmission group was significantly higher than that of non-readmission group(P<0.05). Harris score of hip joint was significantly lower than that of non-readmission group(P<0.05). The proportion of infection,delirium,joint dislocation,anemia and venous thrombosis in readmission group were significantly higher than that of non-readmission group (all P<0.05). Multivariate Logistic regression analysis showed that the risk factors for readmission of elderly patients with hip fracture after hip hemiarthroplasty included cerebral infarction,infection,delirium,dislocation,anemia and venous thrombosis (all P<0.05).

Conclusion: The complications of the elderly patients who were readmission after hip hemiarthroplasty for hip fractures were significantly higher than those who were non-readmission. Cerebral infarction,infection,delirium,dislocation,anemia and venous thrombosis are risk factors that lead to patient readmission. Corresponding intervention measures can be taken clinically based on these risk factors to reduce the incidence of patient readmissions.
KEY WORDS  Aged  Hip  Fractures  Hip replacement  Readmission  Risk factors
 
引用本文,请按以下格式著录参考文献:
中文格式:张婷,赵轶男,牛志霞,全伟,张慧,李志全,刘艳武.高龄髋部骨折行人工髋关节置换术后患者再入院危险因素分析[J].中国骨伤,2022,35(5):460~463
英文格式:ZHANG Ting,ZHAO Yi-nan,NIU Zhi-xia,QUAN Wei,ZHANG Hui,LI Zhi-quan,LIU Yan-wu.Analysis of risk factors for readmission in elderly patients with hip fractures undergoing hip hemiarthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(5):460~463
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