| 入院血尿素及肌酐水平对老年髋部骨折患者病死率的影响 |
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Received:June 20, 2017
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李成宇 |
LI Cheng-yu |
徐州医科大学附属医院骨科, 江苏 徐州 221000 |
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 张星晨 |
ZHANG Xing-chen |
徐州医科大学附属医院骨科, 江苏 徐州 221000 |
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 郑欣 |
ZHENG Xin |
徐州医科大学附属医院骨科, 江苏 徐州 221000 |
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 芮敏 |
RUI Min |
徐州医科大学附属医院骨科, 江苏 徐州 221000 |
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 姚圣城 |
YAO Sheng-cheng |
徐州医科大学附属医院骨科, 江苏 徐州 221000 |
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 宋子健 |
SONG Zi-jiang |
徐州医科大学附属医院骨科, 江苏 徐州 221000 |
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 赵凤朝 |
ZHAO Feng-chao |
徐州医科大学附属医院骨科, 江苏 徐州 221000 |
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 郭开今 |
GUO Kai-jin |
徐州医科大学附属医院骨科, 江苏 徐州 221000 |
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
xzdgkj@sina.com |
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| 期刊信息：《中国骨伤》2017年30卷，第10期，第901-905页 |
| DOI：10.3969/j.issn.1003-0034.2017.10.005 |
| 基金项目:江苏省卫生计生委面上科研课题（编号：H201528）；江苏省级重点研发专项资金项目（编号：BE2015627）；2016年度江苏省普通高校专业学位研究生实践创新计划项目名单（编号：SJLX16_0658）。 |
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目的：观察老年髋部骨折患者的入院血尿素及肌酐水平对病死率的影响。
方法：自2013年1月至2014年12月，收住入院治疗的767例老年髋部骨折患者，男253例，女514例，年龄65～96岁，平均年龄（75.67±6.81）岁。根据入院血尿素、肌酐水平分为4组，A组：尿素≥5 mmol/L、肌酐≥70 μmol/L；B组：尿素≥5 mmol/L、肌酐<70 μmol/L；C组：尿素<5 mmol/L、肌酐≥70 μmol/L；D组：尿素<5 mmol/L、肌酐<70 μmol/L.其中A组：患者211例，男70例，女141例，年龄65～95（80.24±6.51）岁；B组：患者355例，男125例，女230例，年龄65～93（78.46±7.09）岁；C组：患者36例，男11例，女25例，年龄65～95（77.83±6.78）岁；D组：患者165例，男47例，女118例。年龄65～96（76.71±8.35）岁。随访获得四组患者的存活情况，并统计患者在住院期间、术后3、12、18个月病死率，对所获资料进行COX回归分析，并分析入院血尿素及肌酐水平对老年髋部骨折患者病死率的影响。
结果：767例患者获随访18～24（21.33±1.25）个月。随访期间159例患者死亡。入院血尿素、肌酐水平均高者（尿素≥5 mmol/L、肌酐≥70 μmol/L）的院内病死率为2.37%，3、12、18个月病死率分别为9.95%、16.11%及26.07%，均高于其他组（P<0.05）.COX回归分析示年龄[P=0.000，OR=1.378，95%CI （1.172，1.621）]，入院血尿素水平[P=0.000，OR=1.375，95%CI （1.155，1.637）]及血肌酐水平[P=0.037，OR=1.213，95%CI （1.121，1.484）]是患者18个月死亡的独立预测因素。
结论：老年髋部骨折患者入院血尿素及肌酐水平高预示着较高的病死率，年龄、入院时血尿素及肌酐水平是老年髋部骨折的独立预测因素。 |
| [关键词]:髋骨折 血尿素氮 血肌酐 死亡率 老年人 |
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| Effect of admission blood urea and creatinine levels on mortality in elderly patients with hip fracture |
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Abstract:
Objective:To observe the effect of admission blood urea and creatinine levels on mortality in elderly patients with hip fracture.
Methods:Form January 2013 to December 2014,767 elder patients with hip fracture were treated in our hospital including 253 males and 514 females,aged from 65 to 96 years old with an average of(75.67±6.81) years old. According blood urea and creatinine levels,the 767 hip fracture patients were divided into four groups as follow:group A(blood urea≥5 mmol/L,creatinine≥70 μmol/L);group B (blood urea≥5 mmol/L,creatinine<70 μmol/L);group C (blood urea<5 mmol/L,creatinine≥70 μmol/L);group D(blood urea<5 mmol/L,creatinine<70 μmol/L). In group A,there were 211 patients including 70 males and 141 females,aged from 65 to 95 years old with an average of(80.24±6.51) years old;in group B,there were 355 patients including 125 males and 230 females,aged from 65 to 93 years old with an average of(78.46±7.09) years old; in group C,there were 36 patients including 11 males and 25 females,aged from 65 to 95 years old with an average of (77.83±6.78) years old;in group D,there were 165 patients including 47 males and 118 females,aged from 65 to 96 years old with an average of (76.71±8.35) years old. The survivals and dead patients in four groups were collected and in-hospital mortality rate,3-month,12-month and 18-month mortality rate of patients were calculated. COX regression analysis was performed on these data,and clinical significance of serum urea and creatinine at admission in the elderly patients was researched.
Results:All 767 hip fracture patients were followed up from 18 to 24 months with an average of (21.33±1.25) months,159 patients were died in follow up period. The in-hospital mortality rate in 3-month,12-month and 18-month mortality rate of the patients with high blood urea and high blood creatinine (urea≥5 mmol/L,creatinine≥70 μmol/L) were 2.37%,9.95%,16.11% and 26.07%,and were higher than other three groups respectively. COX regression analysis revealed that the independent predictors effecting the mortality rate included age [P=0.000,OR=1.375,95%CI(1.155,1.637)],blood urea at admission [P=0.000,OR=1.375,95%CI(1.155,1.637)],and blood creatinine at admission[P=0.037,OR=1.213,95%CI(1.121,1.484)].
Conclusion:Elderly hip fracture patients with high serum urea and high serum creatinine at admission indicate higher fatality rate. Age,serum urea and serum creatinine at admission were independent predictors of fatality rate of elderly hip fracture patients. |
| KEYWORDS:Hip fractures Blood urea nitrogen Blood creatinine Mortality Aged |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李成宇,张星晨,郑欣,芮敏,姚圣城,宋子健,赵凤朝,郭开今.入院血尿素及肌酐水平对老年髋部骨折患者病死率的影响[J].中国骨伤,2017,30(10):901~905 |
| 英文格式: | LI Cheng-yu,ZHANG Xing-chen,ZHENG Xin,RUI Min,YAO Sheng-cheng,SONG Zi-jiang,ZHAO Feng-chao,GUO Kai-jin.Effect of admission blood urea and creatinine levels on mortality in elderly patients with hip fracture[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(10):901~905 |
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