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中国上海住院老年髋部骨折的流行病学和临床研究。

Epidemiological and clinical study of hip fracture in hospitalized elderly patients in Shanghai, China.

机构信息

Research Section of Geriatric Metabolic Bone Disease, Shanghai Geriatric Institute, Department of Osteoporosis and Bone Disease, Huadong Hospital affiliated to Fudan University, Shanghai, 200040, China.

Research Center on Aging and Medicine, Fudan University, 221 West Yan An Road, Shanghai, 200040, China.

出版信息

Arch Osteoporos. 2019 Mar 12;14(1):37. doi: 10.1007/s11657-019-0580-7.

Abstract

UNLABELLED

In this study, we attempted to determine the epidemiology and clinical characteristics of hip fracture in the elderly. We find that elderly people with hip fracture have multiple comorbidities and suffer numerous complications.

INTRODUCTION

We attempted to explore the epidemiology and clinical characteristics of hip fracture in the elderly.

METHODS

One thousand five hundred thirty-nine patients aged over 65 years were included in the retrospective study. From the medical records, information was gathered about pre-fracture conditions, as well as fracture type, surgical details, laboratory indicators, postoperative complications, length of stay, outcomes, and costs of hospitalization. Binary logistic regression was used to screen for potential risk factors for perioperative complications and postoperative death, and general linear models were used to determine factors that influenced the cost of surgical treatment.

RESULTS

The average age of hip fracture patients in our study was 82.20 ± 6.82 years old, and the male-to-female ratio was 1:2.82. In 1356 patients who underwent hip surgery, the incidence of perioperative complications was 6.71% (91/1356), and the postoperative mortality rate was 1.11% (15/1356). Factors associated with perioperative complications were male sex, heart function class III or higher, serum albumin < 35 g/L, respiratory diseases, and perioperative blood transfusion (P < 0.05). Perioperative blood transfusion was an independent risk factor for postoperative death after hip fracture in the elderly (P < 0.05). The main factors that influenced hospitalization expenses related to elderly hip fracture patients were type of surgery, method of anesthesia, length of stay, perioperative complications, and outcomes (P < 0.05).

CONCLUSIONS

Elderly people with hip fracture have multiple comorbidities and suffer numerous complications. Thus, randomized intervention studies should focus on prevention of complications that might be avoidable.

摘要

目的

本研究旨在探讨老年人髋部骨折的流行病学和临床特征。

方法

回顾性分析 1539 例年龄>65 岁的髋部骨折患者的病历资料,包括骨折前的情况、骨折类型、手术细节、实验室指标、术后并发症、住院时间、治疗效果及住院费用等。采用二分类 Logistic 回归筛选围手术期并发症及术后死亡的潜在危险因素,采用一般线性模型分析影响手术治疗费用的因素。

结果

髋部骨折患者的平均年龄为 82.20±6.82 岁,男女比例为 1:2.82。在 1356 例行髋部手术的患者中,围手术期并发症的发生率为 6.71%(91/1356),术后死亡率为 1.11%(15/1356)。与围手术期并发症相关的因素包括男性、心功能Ⅲ级或以上、血清白蛋白<35 g/L、呼吸系统疾病及围手术期输血(P<0.05)。围手术期输血是老年髋部骨折患者术后死亡的独立危险因素(P<0.05)。影响老年髋部骨折患者住院费用的主要因素为手术类型、麻醉方式、住院时间、围手术期并发症及治疗效果(P<0.05)。

结论

老年髋部骨折患者常合并多种疾病,且易发生多种并发症。因此,应开展针对可预防并发症的随机干预性研究。

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