Yang Zi-Bo, Wu Pei-Hui, Wong Ping-Kwan, Huang Zhi-Yu, Fu Ming, Liao Wei-Ming, He Ai-Shan, Kang Yan
a Department of Orthopaedic & Joint Surgery, the First Affiliated Hospital , Sun Yat-sen University , No.58, Zhongshan 2nd Road, Guangzhou 510080 , P.R. China.
J Invest Surg. 2018 Oct;31(5):431-437. doi: 10.1080/08941939.2017.1333177. Epub 2017 Jul 19.
To compare the postoperative survival and mortality rates in intertrochanteric femoral fracture (IFF) patients who underwent either open reduction internal fixation (ORIF) or hip arthroplasty.
Clinical data from senior patients who had IFF and underwent ORIF or hip arthroplasty were analyzed retrospectively. Survival curves were compared between groups with Kaplan-Meier method and log-rank test. Significant independent prognostic factors were identified by Cox multivariate regression analysis.
All patients recovered fully post-surgery. Although 31 patients died during the follow-up period (ORIF, mean 45.4 months; arthroplasty, mean 51.6 months), mortality rate did not differ significantly between the groups. The 1-yr and 2-yr survival rate estimates for the ORIF group were 92.2%, and 86%, respectively; they were 85% and 74% for the arthroplasty group. Average survival lengths for ORIF and arthroplasty groups were 88 and 67 months, respectively. The effect of surgical approaches on survival differed significantly (log-rank test c2 = 6.402, p = 0.011). Multivariate Cox regression model indicated that surgical choice (p = 0.036) was a significant independent risk factor for the prognosis of senile IFF, even with adjustment for age (p = 0.002).
The overall postoperative prognosis was superior in senile IFF patients treated with ORIF.
比较接受切开复位内固定术（ORIF）或髋关节置换术的股骨粗隆间骨折（IFF）患者的术后生存率和死亡率。
回顾性分析患有IFF并接受ORIF或髋关节置换术的老年患者的临床资料。采用Kaplan-Meier法和对数秩检验比较组间生存曲线。通过Cox多因素回归分析确定显著的独立预后因素。
所有患者术后均完全康复。尽管31例患者在随访期间死亡（ORIF组，平均45.4个月；关节置换术组，平均51.6个月），但两组间死亡率无显著差异。ORIF组1年和2年生存率估计分别为92.2%和86%；关节置换术组分别为85%和74%。ORIF组和关节置换术组的平均生存时长分别为88个月和67个月。手术方式对生存的影响差异显著（对数秩检验c2 = 6.402，p = 0.011）。多因素Cox回归模型表明，即使对年龄进行校正（p = 0.002），手术选择（p = 0.036）仍是老年IFF预后的显著独立危险因素。
接受ORIF治疗的老年IFF患者术后总体预后更佳。
