de Palma Luigi, Torcianti Marco, Meco Leonard, Catalani Alessandro, Marinelli Mario
Orthopaedic Department , Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy,
Eur J Orthop Surg Traumatol. 2014 Jul;24(5):783-8. doi: 10.1007/s00590-013-1241-y. Epub 2013 May 28.
Hip fracture is the third cause of death among the elderly and appears to be increasingly frequent. We analysed the influence of the major variables in hip fracture management in relation to 30-day mortality.
The records of all patients with isolated hip fracture treated at a regional trauma centre from January 1995 to September 2008 were reviewed. Data on demographics, comorbidities, operative delay, complications, functional status at discharge and mortality were collected and subjected to univariate and multivariate analysis.
The cohort included 1,199 patients; the mortality rate was 11.7%. Surgery was performed within 48 h of injury in 17.7% and after more than 48 h in 82.3%; the mortality rate was 9.27% in the former and 10.4% in the latter patients; however, at variance with previous reports, operative delay was not associated with a worse outcome in patients with comorbidities.
Our data support the policy envisaging fracture repair within 48 h in stable patients and delayed surgery (>48 h) in those with comorbidity conditions requiring stabilization.
髋部骨折是老年人死亡的第三大原因，且其发生率似乎越来越高。我们分析了髋部骨折治疗中主要变量对30天死亡率的影响。
回顾了1995年1月至2008年9月在一家地区创伤中心接受治疗的所有单纯性髋部骨折患者的记录。收集了有关人口统计学、合并症、手术延迟、并发症、出院时功能状态和死亡率的数据，并进行了单因素和多因素分析。
该队列包括1199例患者；死亡率为11.7%。17.7%的患者在受伤后48小时内接受了手术，82.3%的患者在受伤后超过48小时接受了手术；前者的死亡率为9.27%，后者为10.4%；然而，与先前的报道不同，手术延迟与合并症患者的不良结局无关。
我们的数据支持以下策略：对于病情稳定的患者，应在48小时内进行骨折修复；对于需要稳定病情的合并症患者，则应延迟手术（>48小时）。
