Komarasamy Baskaran, Forster Mark C, Esler Colin N, Harper William M, Hall Andrew P
Department of Orthopaedics, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK.
Ann R Coll Surg Engl. 2007 Jul;89(5):521-5. doi: 10.1308/003588407X187720.
In an elective setting, surgery is best avoided for at least 6 months following myocardial infarction. However, in the presence of a femoral neck fracture, this would most probably lead to significant complications in relation to prolonged immobilisation. There is no published mortality data for patients undergoing surgery for hip fracture following a recent myocardial infarction. The aim of this retrospective study was to assess the mortality of hip fracture patients with a recent myocardial infarction that have undergone surgery at our institution.
Between January 2003 and October 2005, 2270 patients were admitted to our unit with a proximal femoral fracture. Of these, 11 patients were found to have a recent myocardial infarction.
Of these 11 patients, 8 were female. The average age was 78.2 years (range, 59-90 years). Average delay from the time of infarction to operation was 11.2 days (range, 3-23 days). Mortality at 1 and 6 months was 45.4% and 63.5%, respectively.
This is much higher than the overall reported mortality following proximal femur fracture. This information may be useful when planning future peri-operative care and discussing overall prognosis with patients and their relatives.
在择期情况下，心肌梗死后至少6个月应避免进行手术。然而，对于存在股骨颈骨折的患者，这很可能会因长期制动而导致严重并发症。目前尚无关于近期心肌梗死后接受髋部骨折手术患者的死亡率数据公布。这项回顾性研究的目的是评估在我们机构接受手术的近期心肌梗死髋部骨折患者的死亡率。
2003年1月至2005年10月期间，2270例股骨近端骨折患者入住我们科室。其中，发现11例患者近期发生心肌梗死。
这11例患者中，8例为女性。平均年龄为78.2岁（范围59 - 90岁）。从梗死到手术的平均延迟时间为11.2天（范围3 - 23天）。1个月和6个月时的死亡率分别为45.4%和63.5%。
这远高于报道的股骨近端骨折后的总体死亡率。该信息在规划未来围手术期护理以及与患者及其亲属讨论总体预后时可能有用。
