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85 岁及以上因骨科骨折从急诊科入院患者的 30 天死亡率预测因素。

Predictors of 30-day mortality in orthogeriatric fracture patients aged 85 years or above admitted from the emergency department.

机构信息

Department of Surgery, Sint Antonius Hospital, Nieuwegein, Postbus 2500, 3430 EM, Utrecht, The Netherlands.

Department of Surgery, University Medical Center, Utrecht, The Netherlands.

出版信息

Eur J Trauma Emerg Surg. 2021 Jun;47(3):817-823. doi: 10.1007/s00068-019-01278-z. Epub 2019 Dec 4.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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Dedicated orthogeriatric service reduces hip fracture mortality.专门的老年骨科服务可降低髋部骨折死亡率。
Ir J Med Sci. 2017 Feb;186(1):179-184. doi: 10.1007/s11845-016-1453-3. Epub 2016 Apr 8.

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