Brown Christopher A, Olson Steven, Zura Robert
Department of Orthopedics, Duke University Medical Center, Durham, North Carolina, USA.
J Surg Orthop Adv. 2013 Summer;22(2):160-3. doi: 10.3113/jsoa.2013.0160.
The purpose of this study was to assess the relationship between prefracture characteristics and length of stay (LOS) at the authors' institution. Three hundred eighty-nine consecutive elderly hip fracture patients' preoperative characteristics, comorbidities, fracture type, and surgical and hospital course were retrospectively reviewed. Multiple regression was used to determine which subset of potential independent variables would be good predictors of LOS. Predictors of increased LOS included cerebral vascular disease (+1.28 days, p <.0352), chronic renal insufficiency (+1.17 days, p < .0363), and American Society of Anesthesiologists (ASA) score (+1.27 days per ASA class, p < .0005). For each increase in age by 1 year, LOS decreased by a mean of 0.085 days (p < .0041). Fracture type, prefracture mobility, or other examined comorbidities were found not to be significant predictors of LOS. Identifying high-risk patients in the preoperative period and minimizing certain perioperative events will be important to optimize care of patients who fracture their hip and to minimize future costs.
本研究的目的是评估作者所在机构的骨折前特征与住院时间（LOS）之间的关系。对389例连续的老年髋部骨折患者的术前特征、合并症、骨折类型以及手术和住院过程进行了回顾性分析。采用多元回归分析来确定哪些潜在自变量子集可作为住院时间的良好预测指标。住院时间延长的预测因素包括脑血管疾病（增加1.28天，p <.0352）、慢性肾功能不全（增加1.17天，p <.0363）以及美国麻醉医师协会（ASA）评分（每增加一个ASA等级增加1.27天，p <.0005）。年龄每增加1岁，住院时间平均减少0.085天（p <.0041）。骨折类型、骨折前活动能力或其他检查的合并症并非住院时间的显著预测因素。在术前识别高危患者并尽量减少某些围手术期事件，对于优化髋部骨折患者的护理以及降低未来成本至关重要。
