Department of Surgery, Sint Antonius Hospital, Nieuwegein, Postbus 2500, 3430 EM, Utrecht, The Netherlands.
Department of Surgery, University Medical Center, Utrecht, The Netherlands.
Eur J Trauma Emerg Surg. 2021 Jun;47(3):817-823. doi: 10.1007/s00068-019-01278-z. Epub 2019 Dec 4.
Orthogeriatric trauma patients are at risk for functional decline and mortality. It is important to identify high-risk patients in an early stage, to improve outcomes and make better informed treatment decisions. The aim of this study was to identify independent risk factors for 30-day mortality in patients aged 85 years or above admitted from the emergency department with a fracture.
All orthopaedic trauma patients 85 years or above admitted from the emergency department were included. After a 30-day follow-up, mortality was determined by consulting the patient records. Multivariable logistics regression analysis generated odd ratios for mortality risk factors. A subgroup analysis was performed for patients undergoing hip fracture surgery.
The 30-day mortality in geriatric fracture patients admitted to the hospital was 12%. Risk factors for 30-day mortality were: increased age, male sex, decreased hemoglobin levels, living in an institutional care facility and a decreased BMI. For geriatric patients undergoing hip fracture surgery 30-day mortality was 11%. Independent risk factors for this group were: increased age, male sex, and a decreased BMI.
Orthopaedic trauma patients aged 85 years or above who are admitted to the hospital with a fracture are at high risk for mortality. This study identified older age, male sex, and decreased BMI as predictors of 30-day mortality in admitted geriatric fracture patients and in geriatric hip fracture patients undergoing surgery.
老年创伤患者存在功能下降和死亡的风险。早期识别高危患者对于改善预后和做出更明智的治疗决策非常重要。本研究旨在确定急诊科收治的 85 岁及以上骨折老年患者 30 天死亡率的独立危险因素。
纳入所有从急诊科收治的 85 岁及以上的骨科创伤患者。经过 30 天随访,通过查阅病历确定死亡率。多变量逻辑回归分析得出死亡率风险因素的比值比。对接受髋关节骨折手术的患者进行亚组分析。
住院老年骨折患者的 30 天死亡率为 12%。30 天死亡率的危险因素为:年龄增加、男性、血红蛋白水平降低、居住在机构护理设施和 BMI 降低。对于接受髋关节骨折手术的老年患者,30 天死亡率为 11%。该组的独立危险因素为:年龄增加、男性和 BMI 降低。
因骨折住院的 85 岁及以上的老年创伤患者有很高的死亡风险。本研究确定了年龄较大、男性和 BMI 降低是住院老年骨折患者和接受髋关节骨折手术的老年患者 30 天死亡率的预测因素。