Li Cheng-Yu, Zhang Xing-Chen, Zheng Xin, Rui Min, Yao Sheng-Cheng, Song Zi-Jiang, Zhao Feng-Chao, Guo Kai-Jin
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China.
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China;
Zhongguo Gu Shang. 2017 Oct 25;30(10):901-905. doi: 10.3969/j.issn.1003-0034.2017.10.005.
To observe the effect of admission blood urea and creatinine levels on mortality in elderly patients with hip fracture.
Form January 2013 to December 2014, 767 elder patients with hip fracture were treated in our hospital including 253 males and 514 females, aged from 65 to 96 years old with an average of(75.67±6.81) years old. According blood urea and creatinine levels, the 767 hip fracture patients were divided into four groups as follow: group A(blood urea>=5 mmol/L, creatinine>=70 μmol/L); group B (blood urea>=5 mmol/L, creatinine<70 μmol/L); group C (blood urea<5 mmol/L, creatinine>=70 μmol/L); group D(blood urea<5 mmol/L, creatinine<70 μmol/L). In group A, there were 211 patients including 70 males and 141 females, aged from 65 to 95 years old with an average of(80.24±6.51) years old; in group B, there were 355 patients including 125 males and 230 females, aged from 65 to 93 years old with an average of(78.46±7.09) years old; in group C, there were 36 patients including 11 males and 25 females, aged from 65 to 95 years old with an average of (77.83±6.78) years old; in group D, there were 165 patients including 47 males and 118 females, aged from 65 to 96 years old with an average of (76.71±8.35) years old. The survivals and dead patients in four groups were collected and in-hospital mortality rate, 3-month, 12-month and 18-month mortality rate of patients were calculated. COX regression analysis was performed on these data, and clinical significance of serum urea and creatinine at admission in the elderly patients was researched.
All 767 hip fracture patients were followed up from 18 to 24 months with an average of (21.33±1.25) months, 159 patients were died in follow up period. The in-hospital mortality rate in 3-month, 12-month and 18-month mortality rate of the patients with high blood urea and high blood creatinine (urea>=5 mmol/L, creatinine>=70 μmol/L) were 2.37%, 9.95%, 16.11% and 26.07%, and were higher than other three groups respectively. COX regression analysis revealed that the independent predictors effecting the mortality rate included age [=0.000, OR=1.375, 95%CI(1.155, 1.637)], blood urea at admission [=0.000, OR=1.375, 95%CI(1.155, 1.637)], and blood creatinine at admission[=0.037, OR=1.213, 95%CI(1.121, 1.484)].
Elderly hip fracture patients with high serum urea and high serum creatinine at admission indicate higher fatality rate. Age, serum urea and serum creatinine at admission were independent predictors of fatality rate of elderly hip fracture patients.
观察入院时血尿素和肌酐水平对老年髋部骨折患者死亡率的影响。
2013年1月至2014年12月，我院收治767例老年髋部骨折患者，其中男性253例，女性514例，年龄65～96岁，平均（75.67±6.81）岁。根据血尿素和肌酐水平，将767例髋部骨折患者分为四组：A组（血尿素≥5 mmol/L，肌酐≥70 μmol/L）；B组（血尿素≥5 mmol/L，肌酐＜70 μmol/L）；C组（血尿素＜5 mmol/L，肌酐≥70 μmol/L）；D组（血尿素＜5 mmol/L，肌酐＜70 μmol/L）。A组211例，男性70例，女性141例，年龄65～95岁，平均（80.24±6.51）岁；B组355例，男性125例，女性230例，年龄65～93岁，平均（78.46±7.09）岁；C组36例，男性11例，女性25例，年龄65～95岁，平均（77.83±6.78）岁；D组165例，男性47例，女性118例，年龄65～96岁，平均（76.71±8.35）岁。收集四组患者的生存与死亡情况，计算患者的住院死亡率、3个月、12个月及18个月死亡率。对这些数据进行COX回归分析，研究老年患者入院时血清尿素和肌酐的临床意义。
767例髋部骨折患者均获得18～24个月随访，平均（21.33±1.25）个月，随访期间死亡159例。血尿素和血肌酐水平高（尿素≥5 mmol/L，肌酐≥70 μmol/L）患者的住院死亡率、3个月、12个月及18个月死亡率分别为2.37%、9.95%、16.11%和26.07%，均分别高于其他三组。COX回归分析显示，影响死亡率的独立预测因素包括年龄[P = 0.000，OR = 1.375，95%CI（1.155，1.637）]、入院时血尿素[P = 0.000，OR = 1.375，95%CI（1.155，1.637）]及入院时血肌酐[P = 0.037，OR = 1.213，95%CI（1.121，1.484）]。
老年髋部骨折患者入院时血清尿素和肌酐水平高提示病死率较高。年龄、入院时血清尿素和血清肌酐是老年髋部骨折患者病死率的独立预测因素。
