University of Cambridge, School of Clinical Medicine, Cambridge, UK.
Division of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge, UK.
J Perioper Pract. 2021 Apr;31(4):140-146. doi: 10.1177/1750458920915656. Epub 2020 Apr 17.
Hip fractures are common injuries in the elderly and are associated with significant morbidity and mortality. There are multiple perioperative factors that must be considered when managing these patients. These include analgesia, timing of surgery, choice of operation, type of anaesthesia, postoperative complications and comorbidities. Guidelines from The National Institute for Health and Care Excellence and the National Hip Fracture Database have been updated to reflect many of the above, but the importance of psychosocial factors is still emerging. This article focuses on the evidence for the key perioperative factors in hip fracture management and the tools available to predict hip fracture outcome.
髋部骨折是老年人常见的损伤,与较高的发病率和死亡率相关。在管理这些患者时,有多个围手术期因素需要考虑。这些因素包括镇痛、手术时机、手术选择、麻醉类型、术后并发症和合并症。国家卫生与保健卓越研究所和国家髋部骨折数据库的指南已经更新,以反映上述许多因素,但心理社会因素的重要性仍在显现。本文重点介绍髋部骨折管理中关键围手术期因素的证据,以及预测髋部骨折结局的可用工具。