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髋部骨折患者死亡风险因素的Meta分析。

Metaanalysis of risk factors for mortality in patients with hip fracture.

作者信息

Norring-Agerskov Debbie, Laulund Anne Sofie, Lauritzen Jes Bruun, Duus Benn Rønnow, van der Mark Susanne, Mosfeldt Mathias, Jørgensen Henrik Løvendahl

机构信息

Department of Ortopaedic Surgery, Bispebjerg Hospital.

出版信息

Dan Med J. 2013 Aug;60(8):A4675.

Abstract

INTRODUCTION

The aim of this meta-analysis is to assess the association of three different clinical score systems with the mortality in hip fracture patients.

METHODS

A literature search was conducted on November 13, 2011 using PubMed and Embase. The search yielded 315 publications which were reviewed on the basis of the inclusion criteria.

RESULTS

Thirteen studies were included for further processing. The following clinical score systems were found to be of prognostic value for mortality in hip fracture patients: a high American Society of Anesthesiologists (ASA) score of three or above (odds ratio (OR): 3.07; 95% confidence interval (CI): 2.78-3.38; p < 0.00001, 15,625 study participants included), a Charlson Comorbidity Index (CCI) score of one or more (OR: 2.05; 95% CI: 1.79-2.34; p < 0.00001, 13,570 study participants included) and dementia (assessed with Mini Mental State Examination or obtained from journal extraction) (OR: 2.73; 95% CI: 1.64-4.57; p = 0.0001; 1,782 study participants included).

CONCLUSION

The present meta-analysis showed that the ASA score, the CCI score and assessment of preexisting dementia are useful in predicting the mortality of hip fracture patients.

摘要

引言

本荟萃分析旨在评估三种不同临床评分系统与髋部骨折患者死亡率之间的关联。

方法

于2011年11月13日使用PubMed和Embase进行文献检索。检索得到315篇出版物,并根据纳入标准进行了综述。

结果

纳入13项研究进行进一步分析。发现以下临床评分系统对髋部骨折患者的死亡率具有预后价值:美国麻醉医师协会(ASA)评分3分及以上(优势比(OR):3.07;95%置信区间(CI):2.78 - 3.38;p < 0.00001,纳入15,625名研究参与者)、Charlson合并症指数(CCI)评分1分及以上(OR:2.05;95% CI:1.79 - 2.34;p < 0.00001,纳入13,570名研究参与者)以及痴呆(通过简易精神状态检查表评估或从期刊摘录中获取)(OR:2.73;95% CI:1.64 - 4.57;p = 0.0001;纳入1,782名研究参与者)。

结论

本荟萃分析表明,ASA评分、CCI评分以及对既往痴呆的评估有助于预测髋部骨折患者的死亡率。

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