Department of Endocrinology, Beijing Jishuitan Hospital, Beijing 100035, China.
Chin Med J (Engl). 2013 Mar;126(5):813-8.
Diabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ambulatory ability recovery in individuals with hip fracture, and to determine whether changes could be made to improve treatment outcome.
The study included 707 hip fracture patients treated at Beijing Jishuitan Hospital between July 2009 and December 2010. The medical history and perioperative complications were compared between non-diabetic and diabetic groups. Length of stay, days awaiting surgery, and days of hospitalization after surgery were also analyzed. Ambulatory ability was compared at 1-year follow-up using the Chi-square test and Fisher's exact test. An independent Student's t-test was used to compare normally distributed continuous data.
Patients with diabetes were more likely than non-diabetic patients to develop cardiac perioperative complications (8.9% vs. 3.0%, P = 0.021), urinary tract infections (12.0% vs. 2.8%, P < 0.001), and gastrointestinal symptoms (15.0% vs. 6.8%, P = 0.003). No difference in perioperative complications was observed between the groups. Days awaiting surgery and length of hospital stay were both longer in the diabetic group ((8.0 ± 5.1) vs. (6.2 ± 3.7) days and (16.5 ± 3.8) vs. (13.3 ± 3.8) days, P < 0.001, respectively). Before the occurrence of fracture, patients with diabetes were less likely to be ambulatory outdoors (71.9% vs. 85.9%, P < 0.001) and had more restricted walking ability. After at least 1-year follow-up, similar proportions of patients in the non-diabetic and diabetic groups (16.1% and 15.9%, respectively), who were able to ambulate outdoors before the fracture, became housebound till the final follow-up.
Diabetics are at increased risk of specific complications and have a longer time to surgery and longer in-hospital stay, but generally have similar recovery to non-diabetics thereafter.
糖尿病与骨折风险增加和骨折愈合受损有关。本研究旨在探讨糖尿病对髋部骨折患者围手术期并发症、住院时间和步行能力恢复的影响，并确定是否可以改变治疗结果。
本研究纳入了 2009 年 7 月至 2010 年 12 月在北京积水潭医院治疗的 707 例髋部骨折患者。比较了非糖尿病组和糖尿病组的病史和围手术期并发症。还分析了住院时间、手术等待时间和术后住院天数。采用卡方检验和 Fisher 确切检验比较 1 年随访时的步行能力。采用独立样本 t 检验比较正态分布的连续数据。
与非糖尿病患者相比，糖尿病患者更易发生心脏围手术期并发症（8.9% vs. 3.0%，P=0.021）、尿路感染（12.0% vs. 2.8%，P<0.001）和胃肠道症状（15.0% vs. 6.8%，P=0.003）。两组围手术期并发症无差异。糖尿病组手术等待时间和住院时间均较长（（8.0±5.1）vs.（6.2±3.7）天和（16.5±3.8）vs.（13.3±3.8）天，P<0.001）。在发生骨折之前，糖尿病患者户外活动能力较差（71.9% vs. 85.9%，P<0.001），行走能力受限更多。至少 1 年随访后，骨折前能够户外活动的非糖尿病组和糖尿病组患者比例相似（分别为 16.1%和 15.9%），在最终随访时，两组均有患者不能户外活动。
糖尿病患者特定并发症风险增加，手术时间延长，住院时间延长，但总体恢复情况与非糖尿病患者相似。
