Doruk Hüseyin, Mas M Refik, Yildiz Cemil, Sonmez Alper, Kýrdemir Vecihi
Department of Geriatric Medicine, Gülhane Military Medical Academy, Etlik Ankara 06018, Turkey.
Arch Gerontol Geriatr. 2004 Sep-Oct;39(2):179-85. doi: 10.1016/j.archger.2004.03.004.
The optimal time for the operation of hip fractures in elderly is not clear. Most of the data indicate that early operation is associated with better prognosis and improved health quality. We aimed to investigate the effect of timing of surgical intervention on the frequency of post-operative complications, recovery of weight bearing ability, total hospitalization time and activities of daily living (ADL) scores. Sixty five patients subjected to surgical repair were followed up. All were evaluated for their ADL before fracture, post-operative 1st, 3rd, 6th and 12th month. The patients operated within 5 days after hospitalization constituted the early group (n = 38, 24 females, 14 males; mean age = 76.16 +/- 7.08 years), and the patients operated after the fifth day served as the late group (n = 27, 18 females, 9 males; mean age = 75.81 +/- 7.50). Time of recovery of weight bearing ability and total hospitalization time were significantly higher in the late group (P < 0.05). ADL scores in 1st, 3rd and 6th month after surgery were significantly lower (P < 0.05), and death rates on post-operative 1st and 12th month were significantly higher in the late group (P < 0.05). Elderly, operated within 5 days of the hip fracture have increased survival time and better life quality than those operated after the fifth day of the admission. The data supports the previous reports which indicate the necessity of the early operation of elderly hip fractures.
老年髋部骨折的最佳手术时间尚不清楚。大多数数据表明,早期手术与更好的预后和更高的健康质量相关。我们旨在研究手术干预时机对术后并发症发生率、负重能力恢复、总住院时间和日常生活活动(ADL)评分的影响。对65例行手术修复的患者进行了随访。所有患者在骨折前、术后第1、3、6和12个月均进行了ADL评估。住院后5天内手术的患者组成早期组(n = 38,24例女性,14例男性;平均年龄 = 76.16 +/- 7.08岁),术后第5天以后手术的患者作为晚期组(n = 27,18例女性,9例男性;平均年龄 = 75.81 +/- 7.50)。晚期组的负重能力恢复时间和总住院时间显著更长(P < 0.05)。术后第1、3和6个月的ADL评分显著更低(P < 0.05),晚期组术后第1和12个月的死亡率显著更高(P < 0.05)。髋部骨折后5天内接受手术的老年人比入院后第5天以后接受手术的老年人存活时间更长,生活质量更好。这些数据支持了先前表明老年髋部骨折早期手术必要性的报告。