| 老年髋部骨折术后1年急性脑血管事件发生危险因素及预后分析 |
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投稿时间：2023-11-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 骆洪涛 |
LUO Hong-tao |
中国人民解放军空军特色医学中心骨科, 北京 100098 |
Department of Orthopaedics, PLA Air Force Medical Center, Beijing 100098, China |
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| 闫伟 |
YAN Wei |
中国人民解放军空军特色医学中心骨科, 北京 100098 |
Department of Orthopaedics, PLA Air Force Medical Center, Beijing 100098, China |
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| 姚青阳 |
YAO Qing-yang |
中国人民解放军空军特色医学中心骨科, 北京 100098 |
Department of Orthopaedics, PLA Air Force Medical Center, Beijing 100098, China |
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| 郑力通 |
ZHENG Li-tong |
中国人民解放军空军特色医学中心骨科, 北京 100098 |
Department of Orthopaedics, PLA Air Force Medical Center, Beijing 100098, China |
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| 门鹏翔 |
MEN Peng-xiang |
中国人民解放军空军特色医学中心骨科, 北京 100098 |
Department of Orthopaedics, PLA Air Force Medical Center, Beijing 100098, China |
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| 王金强 |
WANG Jin-qiang |
中国人民解放军空军特色医学中心骨科, 北京 100098 |
Department of Orthopaedics, PLA Air Force Medical Center, Beijing 100098, China |
LUOht@sohu.com |
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| 期刊信息：《中国骨伤》2023年，第36卷，第12期，第1119-1124页 |
| DOI：10.12200/j.issn.1003-0034.2023.12.003 |
| 基金项目: |
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中文摘要:
目的:探讨老年髋部骨折术后1年内发生急性脑血管事件的危险因素及预后影响。
方法:回顾性分析2017年7月至2020年12月收治老年髋部骨折320例,男111例,女209例;年龄60~101(79.05±8.48)岁。根据术后1年内是否发生急性脑血管事件,将患者分为脑血管事件和无脑血管事件组。收集患者的临床资料,包括年龄、性别、合并症、骨折类型、白细胞计数、血红蛋白、白蛋白、独立生活能力(activities of daily living,ADL)评分、行走能力、麻醉方式、手术方式和住院时间,通过单因素分析和多因素Logistic回归分析老年髋部骨折术后1年内急性脑血管事件的独立危险因素,比较两组术后1年ADL、行走能力和死亡率等。
结果:术后1年内38例(11.9%)发生急性脑血管事件,脑血管事件组男20例,女18例,年龄(82.53±7.91)岁;非脑血管事件组男91例,女191例,年龄(78.59±8.46)岁。单因素分析结果显示急性脑血管事件与年龄(t=2.712,P=0.007)、男性(χ2=6.129,P=0.013)、高血压病(χ2=8.449,P=0.004)、心律失常(χ2=6.360,P=0.012)、脑卒中(χ2=34.887,P=0.000)、糖尿病(χ2=4.574,P=0.032)和住院时间(t=2.249,P=0.025)密切相关。多因素Logistic回归分析显示年龄(OR=1.068,P=0.018)、男性(OR=2.875,P=0.008)、心律失常(OR=2.722,P=0.017)和脑卒中(OR=7.382,P=0.000)是术后1年并发急性脑血管事件的独立危险因素。脑血管事件组患者术后1年死亡(11例)与无脑血管组(41例)比较,差异有统计学意义(χ2=5.108,P=0.024)。脑血管事件组患者术后1年ADL评分(58.70±14.45)分与无脑血管事件组(67.83±10.45)分比较,差异有统计学意义(t=4.122,P=0.000)。脑血管事件组患者术后1年独立行走、辅助行走和卧床分别为3、17和 7例,无脑血管事件组分别为54例、174例和13例,差异有统计学意义(χ2=11.030,P=0.003)。
结论:老年髋部骨折术后1年易并发急性脑血管事件,其中年龄、男性、心律失常和脑卒中病史是急性脑卒中发生的独立危险因素。脑血管事件组患者术后1年死亡率更高,生活自理能力和行走能力更差。 |
| 【关键词】老年 髋部骨折 脑卒中 死亡率 |
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| Risk factors and prognosis of acute cerebrovascular events at 1 year after hip fracture in elderly patients |
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ABSTRACT
Objective To investigate risk factors of acute cerebrovascular events and effects on the prognosis within 1 year after hip fracture surgery.
Methods A retrospective analysis was performed on 320 elderly patients with hip fracture treated from July 2017 to December 2020,including 111 males and 209 females,aged from 60 to 101 years old with an average of (79.05±8.48) years old. According to whether acute cerebrovascular events occurred within 1 year after surgery,patients were divided into cerebrovascular events and non-cerebrovascular events group. Clinical data of patients were collected,including age,sex,comorbidities,fracture type,white blood cell count,hemoglobin,albumin,activities of daily living (ADL) score,walking ability,type of anesthesia,type of surgery,and length of hospital stay,Univariate analysis and multivariate Logistic regression were used to analyze the independent risk factors of acute cerebrovascular events within 1 year after hip fracture in elderly patients. ADL,walking ability and mortality were compared between the two groups 1 year after surgery.
Results Acute cerebrovascular events occurred in 38 patients (11.9%) within 1 year after surgery. In the cerebrovascular events group,there were 20 males and 18 females,aged (82.53±7.91) years. In the non-cerebrovascular event group,there were 91 males and 191 females,aged with an average of (78.59±8.46) years old. Univariate analysis showed that acute cerebrovascular events were associated with age (t=2.712,P=0.007),male (χ2=6.129,P=0.013),hypertension (χ2=8.449,P=0.004),arrhythmia (χ2=6.360,P=0.012),stroke history (χ2=34.887,P=0.000),diabetes mellitus (χ2=4.574,P=0.032) and length of hospital stay (t=2.249,P=0.025) were closely related. Multivariate Logistic regression analysis showed age (OR=1.068,P=0.018),male (OR=2.875,P=0.008),arrhythmia (OR=2.722,P=0.017) and stroke history (OR=7.382,P=0.000) was an independent risk factor for acute cerebrovascular events 1 year after surgery. The patients with cerebrovascular events died at 1 year after surgery (11 cases) compared with those without cerebrovascular events (41 cases),and the difference was statistically significant(χ2=5.108,P=0.024). ADL scores of patients with cerebrovascular events at 1 year after operation were (58.70±14.45) points compared with those without cerebrovascular events (67.83±10.45) points,and the difference was statistically significant(t=4.122,P=0.000). Independent walking,assisted walking and bed rest were 3,17 and 7 cases in cerebrovascular event group,and 54,174 and 13 cases in non-cerebrovascular event group,respectively;and the difference was statistically significant(χ2=11.030,P=0.003).
Conclusion Acute cerebrovascular events were common in elderly patients 1 year after hip fracture. Age,male,arrhythmia and stroke history were independent risk factors for acute stroke. The patients in the cerebrovascular event group had higher mortality and worse self-care ability and walking ability one year after operation. |
| KEY WORDS Elderly Hip fracture Stroke Mortality |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 骆洪涛,闫伟,姚青阳,郑力通,门鹏翔,王金强.老年髋部骨折术后1年急性脑血管事件发生危险因素及预后分析[J].中国骨伤,2023,36(12):1119~1124 |
| 英文格式: | LUO Hong-tao,YAN Wei,YAO Qing-yang,ZHENG Li-tong,MEN Peng-xiang,WANG Jin-qiang.Risk factors and prognosis of acute cerebrovascular events at 1 year after hip fracture in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(12):1119~1124 |
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