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髋部骨折死亡率:转子间骨折与股骨颈骨折的差异

Hip Fracture Mortality: Differences Between Intertrochanteric and Femoral Neck Fractures.

作者信息

Frisch Nicholas B, Wessell Nolan, Charters Michael, Greenstein Alexander, Shaw Jonathan, Peterson Edward, Trent Guthrie S

机构信息

Ascension Crittenton Hospital, DeClaire LaMacchia Orthopaedic Institute, Rochester Hills, Michigan.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado.

出版信息

J Surg Orthop Adv. 2018 Spring;27(1):64-71.

Abstract

The purpose of this study was to identify the specific risk factors that affect mortality in patients with hip fractures and differentiate mortality-associated factors between intertrochanteric (IT) and femoral neck (FN) fractures. A total of 1538 consecutive patients with hip fractures were treated at the authors' institution between January 2005 and October 2013. Ultimately 858 IT and 479 FN fracture patients were included on the basis of age >60 years with an isolated hip fracture. Mortality rate at 90 days was 12.1% for IT and 9.6% for FN fractures. In both IT and FN fractures, variables associated with mortality risk include increased age, greater days to surgery, male gender, decreased body mass index, and increased American Society of Anesthesiologists score. When evaluated independently, the presence of cardiac arrhythmia and chronic kidney disease was strongly associated with greater mortality risk in FN fracture patients. The presence of chronic kidney disease and hypertension correlated with decreased mortality risk among FN fracture patients. (Journal of Surgical Orthopaedic Advances 27(1):64-71, 2018).

摘要

本研究的目的是确定影响髋部骨折患者死亡率的具体危险因素,并区分粗隆间(IT)骨折和股骨颈(FN)骨折之间与死亡率相关的因素。2005年1月至2013年10月期间,共有1538例连续的髋部骨折患者在作者所在机构接受治疗。最终,858例IT骨折患者和479例FN骨折患者被纳入研究,纳入标准为年龄>60岁且为单纯髋部骨折。IT骨折患者90天死亡率为12.1%,FN骨折患者为9.6%。在IT骨折和FN骨折中,与死亡风险相关的变量包括年龄增加、手术天数增加、男性、体重指数降低以及美国麻醉医师协会评分增加。单独评估时,心律失常和慢性肾病的存在与FN骨折患者更高的死亡风险密切相关。慢性肾病和高血压的存在与FN骨折患者死亡风险降低相关。(《外科骨科进展杂志》27(1):64 - 71, 2018)

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