摘要
背景:目前国内外学者普遍认为髋部骨折患者术后死亡率高,但对于影响死亡率相关因素的意见不一致。我国学者大多将研究重点放在髋部骨折手术治疗的相关问题上,少有学者关注术后死亡率的影响因素。目的:初步分析影响髋部骨折患者术后死亡率的相关因素。方法:随访研究2005年1月至2011年12月的107例髋部骨折患者,男41例,女66例;年龄50～106岁,平均(75.7±10.9)岁。分析患者的社会状况、医疗情况对死亡率的影响,采用Kaplan-Meier法描述患者的生存率,Log-rank检验、Cox回归分析患者死亡率的相关因素。结果:年龄80岁、合并症2种、术后出现并发症均为影响患者死亡率的危险因素;脑部功能异常可至患者早期(2年内)死亡率增加;性别、骨折后至手术时间、手术持续时间、术中出血量均与死亡率无显著相关性。结论:应对高龄、合并症多,尤其是存在脑部功能异常、出现术后并发症的髋部骨折患者给予积极治疗,从而降低患者的术后死亡率。
Background： At present, there is a high postoperative mortality rate in hip fracture patients. But the factors related to mortali- ty are still uncertain. Few researchers pay attention to the related factors of postoperative death for hip fracture. Objective： To explore the influencing factors of postoperative mortality of the patients with hip fracture. Methods： The clinical data of 107 patients with hip fracture, who underwent treatment from January 2005 to December 2011, were retrospectively analyzed. There were 41 males and 66 females with an average age of 75.7± 10.9 years （range from 50 to 106 years）. The effect of social condition and medical condition on the mortality was analyzed. Kaplan-Meier curve was used to describe survival rate. Log-rank test and Cox＇s regression model was applied to find the related factors with the patient＇ s mortality. Results： Age （≥ 80 years）, chronic comorbidities （ ≥ 2）, postoperative complications were the risk factors related to patient＇s death. The brain dysfunction caused the increase of mortality in the two year after surgery. The mortality was not signifcantly correlated with age, duration from fracture to treatment, operative time and blood loss during surgery. Conclusions： In order to reduce the postoperative mortality, we should give more attention to the patients who are senior citizen, have comorbidities, especially brain dysfunction, postoperative complications.
出处
《中国骨与关节外科》
2012年第6期476-480,共5页
Chinese Journal of Bone and Joint Surgery
基金
北京市丰台区科技三项费项目
关键词
髋部骨折
死亡率
hip fracture
mortality
