Lin Wei-Ting, Chao Chien-Ming, Liu Hsuan-Chih, Li Yi-Ju, Lee Wei-Jing, Lai Chih-Cheng
Department of Orthopedics, Chi Mei Medical Center, Tainan, Taiwan; Department of Physical Therapy, Shu Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.
Departments of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan; Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan.
PLoS One. 2015 May 15;10(5):e0125496. doi: 10.1371/journal.pone.0125496. eCollection 2015.
The knowledge about short-term outcomes of nonagenarians undergoing surgery for hip fracture in Asian is limited.
The patients with hip fractures who underwent hip hemiarthroplasty and open reduction with internal fixation (ORIF) for management during the period from 2008 to 2012 were identified and their medical record was retrospectively reviewed.
During the study period, a total of 101 patients underwent surgery for management of hip fractures, and the age of patients ranged from 90 to 96 years. The sites of hip fracture were intertrochanteric (n = 57, 56.4%) and the neck of the femur (n = 44, 43.6%). Most of the patients had American Society of Anesthesiologists scores of 3(n = 55) or 4 (in 44 patients). 80.2% (n = 81) underwent the operation within one day after admission; however, there were 13 patients (12.9%) that underwent surgery 48 or more hours later. ORIF and hemiarthroplasty were performed for 63 (62.4%) and 38 (37.6%) patients, respectively. Overall, the 30-day and 1-year mortality rates were 9.9% (10/101) and 17.3% (13/75), respectively. Multivariate analysis showed that the 30-day mortality was significantly associated only with end-stage renal disease (ESRD) (Odds ratio, 11.13, 95% confidence interval, 1.275-97.881, P = .029).
The short-term outcome of surgical management for Asian nonagenarians with hip fractures is favorable in selected patients.
关于亚洲百岁老人髋部骨折手术短期预后的知识有限。
确定2008年至2012年期间接受髋部半关节置换术和切开复位内固定术（ORIF）治疗髋部骨折的患者，并对其病历进行回顾性分析。
在研究期间，共有101例患者接受了髋部骨折手术治疗，患者年龄在90至96岁之间。髋部骨折部位为转子间（n = 57，56.4%）和股骨颈（n = 44，43.6%）。大多数患者的美国麻醉医师协会评分为3分（n = 55）或4分（44例患者）。80.2%（n = 81）的患者在入院后一天内接受了手术；然而，有13例患者（12.9%）在48小时或更长时间后接受了手术。分别对63例（62.4%）和38例（37.6%）患者进行了ORIF和半关节置换术。总体而言，30天和1年死亡率分别为9.9%（10/101）和17.3%（13/75）。多因素分析显示，30天死亡率仅与终末期肾病（ESRD）显著相关（比值比，11.13，95%置信区间，1.275 - 97.881，P = .029）。
对于部分亚洲百岁髋部骨折患者，手术治疗的短期预后良好。
