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老年人群股骨近端骨折后的院内死亡率

In-Hospital Mortality following Proximal Femur Fractures in Elderly Population.

作者信息

Ram Ganesan G, Govardhan Praveen

机构信息

Department of Orthopaedics, Sri Ramachandra Medical College, Porur, Chennai, India.

Department of Orthopaedics, Vasanthi Orthopaedic Hospital, Arumbakkam, Chennai, India.

出版信息

Surg J (N Y). 2019 Jul 16;5(2):e53-e56. doi: 10.1055/s-0039-1692995. eCollection 2019 Apr.

Abstract

In India, hip fracture crude incidence above the age of 50 years was 129 per 100,000.  The aim of this study is to analyze the in-hospital mortality following proximal femur fractures in elderly Indian population.  The study was done in Sri Ramachandra Medical Center, Chennai, India. Patient's records were retrospectively evaluated for a period of 3 years from January 1, 2015 to January 1, 2018. The inclusion criteria were patients both male and female aged more than 65 years admitted with the diagnosis of neck of femur or intertrochanteric or subtrochanteric fractures. The exclusion criteria were patients having any associated fracture or previous hip fracture history or diagnosed primary or secondary malignancies. To evaluate any surgical delay two groups were formed. After eliminating cases based on exclusion criteria, we had 270 patients for evaluation.  The collected data were analyzed with IBM.SPSS statistics software 23.0 Version. To describe about the data descriptive statistics frequency analysis, percentage analysis were used for categorical variables and the mean and standard deviation (SD) were used for continuous variables. To find the significant difference between the bivariate samples, Student's -test and analysis of variance (ANOVA) were used. The -value of 0.05 is considered as significant level.  We had a total of 24 mortalities with 15 males and 9 females. The in-hospital mortality of patients who underwent replacement surgeries for proximal femur fractures was 14 in our study. Sixteen of the in-hospital mortality patients had low Parker's mobility score. Twenty patients had mortality when surgery was delayed more than 48 hours.  In-hospital mortality in elderly patients having proximal femur fracture increases significantly if the patient was having low-preoperative mobility status, if surgery was delayed more than 48 hours, and if patient undergoes replacement surgeries.

摘要

在印度,50岁以上人群髋部骨折的粗发病率为每10万人中有129例。 本研究的目的是分析印度老年人群股骨近端骨折后的住院死亡率。 该研究在印度钦奈的斯里兰卡拉马钱德拉医学中心进行。对2015年1月1日至2018年1月1日这3年期间的患者记录进行回顾性评估。纳入标准为年龄超过65岁、因股骨颈骨折、转子间骨折或转子下骨折入院的男性和女性患者。排除标准为有任何合并骨折、既往髋部骨折史或诊断为原发性或继发性恶性肿瘤的患者。为评估手术延迟情况,将患者分为两组。根据排除标准剔除病例后,有270例患者可供评估。 收集的数据使用IBM.SPSS统计软件23.0版本进行分析。为描述数据,分类变量采用描述性统计频率分析、百分比分析,连续变量采用均值和标准差(SD)分析。为找出双变量样本之间的显著差异,采用了学生t检验和方差分析(ANOVA)。P值为0.05被视为显著水平。 我们共有24例死亡病例,其中男性15例,女性9例。在我们的研究中,接受股骨近端骨折置换手术患者的住院死亡率为14例。16例住院死亡患者的帕克活动评分较低。手术延迟超过48小时的患者中有20例死亡。 如果患者术前活动状态较差、手术延迟超过48小时以及接受置换手术,老年股骨近端骨折患者的住院死亡率会显著增加。

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