摘要
目的对老年股骨颈骨折保守治疗患者2年生存率的相关影响因素进行分析。方法回顾性分析自2015年1月1日-2018年1月1日于解放军总医院第六医学中心门急诊就诊的63例股骨颈骨折保守治疗患者,其中男24例,年龄(85.54±5.61)岁;女39例,年龄(84.13±5.38)岁。63例中高血压病40例(63.5%),糖尿病24例(38.1%),冠心病42例(66.7%),肺部感染34例(54.0%),慢性阻塞性肺疾病(COPD)27例(42.9%),心力衰竭11例(17.5%),低蛋白血症24例(38.1%),痴呆16例(25.4%),肾功能衰竭7例(11.1%),每天非卧床时间小于2 h者28例(44.4%)。所有患者随访至伤后2年,记录患者生存情况。单因素分析及多元Cox回归分析死亡相关危险因素。结果随访2年,63例中43例生存,20例死亡,死亡率31.7%。单因素分析提示肺部感染、低蛋白血症、每日非卧床时间小于2 h与2年生存率相关。进一步行多因素分析结果显示肺部感染(HR:7.145,95%CI:1.631~31.308)及每日非卧床时间≤2 h(HR:5.564,95%CI:1.825~16.962)是影响伤后2年生存率的独立危险因素。结论老年股骨颈骨折保守治疗患者积极改善全身状态,尤其注意少卧床、预防肺部感染,有助于延长寿命。
Objective To analyze the factors influencing 2-year survival rate in elderly patients with femoral neck fracture treated conservatively.Methods From January 1,2015 to January 1,2018,63 patients with femoral neck fracture treated conservatively in the Sixth Medical Center of Chinese PLA General Hospital were included.There were 24 males and 39 females,with the mean age of(85.54±5.61)years and(84.13±5.38)years respectively.Hypertension was found in 40 cases(63.5%),diabetes in 24 cases(38.1%),coronary heart disease(CHD)in 42 cases(66.7%),lung infection in 34 cases(54.0%),chronic obstructive pulmonary disease(COPD)in 27 cases(42.9%),heart failure in 11 cases(17.5%),hypoproteinemia in 24 cases(38.1%),dementia in 16 cases(25.4%),renal failure in 7 cases(11.1%),non-stay in bed time less than 2 hour per day in 28 cases(44.4%).All patients were followed up for 2 years after injury to observe the survival.Univariate analysis and multivariate Cox regression analysis were applied to explore independent risk factors related to death.Results After 2 years of follow-up,43 of the 63 patients survived and 20 died,with a mortality rate of 31.7%.Univariate analysis suggested that pulmonary infection,hypoproteinemia,and non-stay in bed time less than 2 hours per day were associated with 2-year survival rate.Further multivariate analysis showed that pulmonary infection(HR,7.145;95%CI[1.631,31.308])and non-stay in bed time less than 2 hours per day(HR,5.564;95%CI[1.825,16.962])were independent risk factors for 2-year survival rate after injury.Conclusion Elderly patients with femoral neck fracture treated conservatively should spend less time lying in bed and pay more attention to the prevention of pulmonary infection,and active cough and enhanced sputum should be suggested to help to prolong life.
作者
胡婷婷
袁伟
于明
张凯博
HU Tingting;YUAN Wei;YU Ming;ZHANG Kaibo(Department of Cadre Health,the Sixth Medical Center,Chinese PLA General Hospital,Beijing 100048,China;Department of Orthopaedics,Specialty Medical Center of Strategic Support Force,Beijing 100101,China;Outpatient Department,Jingnan Medical District,Chinese PLA General Hospital,Beijing 100036,China;Training Department,Medical Service Department,Chinese PLA General Hospital,Beijing 100853,China)
出处
《解放军医学院学报》
CAS
2020年第7期701-704,共4页
Academic Journal of Chinese PLA Medical School
关键词
老年患者
股骨颈骨折
保守治疗
死亡率
危险因素
elderly patients
femoral neck fracture
conservative treatment
mortality
risk factor
