Eiskjaer S, Ostgård S E
Department of Orthopaedic Surgery E, Arhus Kommunehospital, University of Arhus, Denmark.
Clin Orthop Relat Res. 1991 Sep(270):295-300.
The hospital records of 204 patients (mean age 80 years, range 54-96 years) with a displaced intracapsular femoral neck fracture treated by cemented bipolar hemiarthroplasty were examined to record all available data on factors suspected of influencing mortality. The data were analyzed statistically using survival analysis (Cox model). The six months mortality rate was 20% and the one year mortality rate was 28%. The following factors, in order to decreasing importance, had significant influence on mortality: cardiac factors other than previous myocardial infarction; status as a nursing home patient; chronic pulmonary disease; serum creatinine level greater than 1.7 mg/100 ml; pneumonia; previous myocardial infarction; duration of surgery; and gender. The following factors had no significant influence on mortality: age, time delay from admission to surgery, mode of anesthesia, and cerebrovascular diseases. In conclusion, medical conditions were the most important determinants of survival in the present study. The time delay between admission and surgery did not influence the chances of survival. This does not mean that surgical delay beyond that essential for stabilizing the patient is not problematic, but indicates that ample time should be spent on assessment and resuscitation before surgery.
对204例采用骨水泥型双极半髋关节置换术治疗的移位型股骨颈囊内骨折患者（平均年龄80岁，范围54 - 96岁）的医院记录进行了检查，以记录所有关于疑似影响死亡率因素的可用数据。使用生存分析（Cox模型）对数据进行统计学分析。六个月死亡率为20%，一年死亡率为28%。以下因素按重要性递减顺序对死亡率有显著影响：除既往心肌梗死外的心脏因素；养老院患者身份；慢性肺病；血清肌酐水平大于1.7mg/100ml；肺炎；既往心肌梗死；手术持续时间；以及性别。以下因素对死亡率无显著影响：年龄、入院至手术的时间延迟、麻醉方式和脑血管疾病。总之，在本研究中，医疗状况是生存的最重要决定因素。入院与手术之间的时间延迟不影响生存机会。这并不意味着超过稳定患者所需的必要手术延迟没有问题，而是表明在手术前应花足够的时间进行评估和复苏。
