Higashikawa Toshihiro, Shigemoto Kenji, Goshima Kenichi, Usuda Daisuke, Okuro Masashi, Moriyama Manabu, Inujima Hiromi, Hangyou Masahiro, Usuda Kimiko, Morimoto Shigeto, Matsumoto Tadami, Takashima Shigeki, Kanda Tsugiyasu, Sawaguchi Takeshi
Department of Geriatric Medicine, Kanazawa Medical University Himi Municipal Hospital, 1130, Kurakawa, Himi, Toyama 935-8531.
Kanazawa Medical University, Uchinada, Kahoku-gun, Ishikawa 920-0293.
Medicine (Baltimore). 2020 Feb;99(7):e19108. doi: 10.1097/MD.0000000000019108.
Aspiration pneumonia (AP) has been recognized as one of the most common postoperative complications after hip surgery in elderly. The objective of the present study was to evaluate risk for postoperative complications of AP in elderly patients with femoral neck fractures.We recruited 426 patients (age 84.9 ± 7.4 years) with a history of hip surgery carried out at Toyama Municipal Hospital. AP occurred in 18 out of 426 cases (4.23%). Statistical test has found significant differences in age, gender, serum albumin level, and cognitive impairment, between AP and non-AP groups. Subsequently multiple logistic regression analysis was conducted to investigate the risk factors for AP, including age, gender, serum albumin, cognitive impairment, and activities of daily living (ADL). Adjusted odds ratio showed significant differences in age, gender, and serum albumin, whereas no significant differences were found in cognitive impairment and ADL.This study suggested that serum albumin seemed to be a risk factor for AP but were necessary to assess under adjustment of confounding factors, including age and gender. Monitoring serum albumin level seemed to be important for the postoperative management of AP, especially in elderly patients receiving surgery of femoral neck and trochanteric fractures.
吸入性肺炎（AP）被认为是老年患者髋关节手术后最常见的术后并发症之一。本研究的目的是评估老年股骨颈骨折患者术后发生AP并发症的风险。我们招募了426例在富山市民医院接受过髋关节手术的患者（年龄84.9±7.4岁）。426例病例中有18例发生AP（4.23%）。统计检验发现，AP组和非AP组在年龄、性别、血清白蛋白水平和认知障碍方面存在显著差异。随后进行了多因素logistic回归分析，以研究AP的危险因素，包括年龄、性别、血清白蛋白、认知障碍和日常生活活动能力（ADL）。调整后的比值比显示年龄、性别和血清白蛋白存在显著差异，而认知障碍和ADL方面未发现显著差异。本研究表明，血清白蛋白似乎是AP的一个危险因素，但需要在调整包括年龄和性别在内的混杂因素后进行评估。监测血清白蛋白水平对AP的术后管理似乎很重要，尤其是对于接受股骨颈和转子间骨折手术的老年患者。
