Department of Orthopaedics, Sykehuset Innlandet Hospital Trust, Elverum, Norway.
Arch Orthop Trauma Surg. 2012 Dec;132(12):1753-8. doi: 10.1007/s00402-012-1611-7. Epub 2012 Sep 21.
In the elderly, hip fracture is a common injury associated with high early mortality dominated by cardiorespiratory and thromboembolic events. Identification of risk factors that can be modified by treatment has caught attention over the last years. This study was conducted to assess biological markers on perioperative organ dysfunction and its association with early mortality within 3 months after surgery.
Blood samples were collected before, during and until 4 days after surgery. Analyses on PaO(2), alanine aminotransaminase (ALAT), gamma-glutamyl transpeptidase (g-GT) and creatinine were performed and used as markers on lung, liver and kidney functions.
Three hundred and two patients over 75 years of age with acute dislocated hip fracture were consecutively enrolled from two hospitals in Norway.
We found a positive correlation between the plasma levels of ALAT, creatinine and death, and an inverse relationship between PaO(2) and death. After controlling for confounding factors such as sex, age and comorbidity, ALAT and creatinine levels were shown to be significantly and independently related to risk for fatal outcome.
Our results provide data on clinically important biomarkers in patients undergoing hip fracture surgery. We suggest a stronger emphasis on monitoring and correcting these biomarkers when possible.
在老年人中，髋部骨折是一种常见的损伤，与心肺和血栓栓塞事件为主的早期高死亡率相关。近年来，人们对能够通过治疗改变的风险因素的识别引起了关注。本研究旨在评估围手术期器官功能障碍的生物标志物及其与术后 3 个月内早期死亡率的关系。
在术前、术中和术后 4 天内采集血样。分析 PaO(2)、丙氨酸氨基转移酶 (ALAT)、γ-谷氨酰转肽酶 (g-GT) 和肌酐，作为肺、肝和肾功能的标志物。
挪威两家医院连续收治了 302 名 75 岁以上急性脱位性髋部骨折患者。
我们发现 ALAT、肌酐和死亡之间呈正相关，而 PaO(2)与死亡呈负相关。在控制性别、年龄和合并症等混杂因素后，ALAT 和肌酐水平与致命结局的风险显著且独立相关。
我们的研究结果提供了髋部骨折手术患者临床重要生物标志物的数据。我们建议在可能的情况下，更加强调监测和纠正这些生物标志物。
