Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, P.R. China.
Department of Orthopaedic Surgery, Chinese PLA General Hospital, 301 Hospital, Beijing 100853, P.R. China.
Aging (Albany NY). 2020 Jul 10;12(13):13583-13593. doi: 10.18632/aging.103466.
We aimed to investigate whether super elderly patients aged over 90 years had significantly worse functional outcomes, perioperative complications, and survival rates. Among 3560 patients aged over 65 years presenting with intertrochanteric fractures and treated surgically between Jan 2014 and Jan 2019, 2242 patients were included, including 206 in super elderly group and 2036 in elderly group. After using propensity score matching to minimize the effects of possible confounding variables, 192 remained in each group. No significant difference was observed in functional outcomes, perioperative complications, or 30-day, 90-day, and 1-year mortality after propensity score matching and McNemar's tests (>0.05). After an average follow-up of 37 months, the Kaplan-Meier survival curve showed no significant difference between the two groups in terms of cumulative survival rate (=0.081, log-rank). Our data demonstrated progressive increases in mortality and poor outcomes with increasing Elixhauser comorbidity scores, which represented the severity index of patients preoperatively. Our study also found that there were weak correlations between five characteristics and the patient age. These results all suggested that it is not the advanced age itself but other concomitant factors, that appear to be responsible for the adverse functional outcomes, perioperative complications, and mortality in super elderly patients.
我们旨在探讨 90 岁以上超高龄患者的功能预后、围手术期并发症和生存率是否显著更差。在 2014 年 1 月至 2019 年 1 月接受手术治疗的 3560 名年龄超过 65 岁的转子间骨折患者中,纳入了 2242 名患者,其中超级老年组 206 名,老年组 2036 名。在使用倾向评分匹配最小化可能混杂因素的影响后,每组仍有 192 名患者。在倾向评分匹配和 McNemar 检验后(>0.05),功能预后、围手术期并发症以及 30 天、90 天和 1 年死亡率无显著差异。平均随访 37 个月后,两组之间的 Kaplan-Meier 生存曲线在累积生存率方面没有显著差异(=0.081,对数秩检验)。我们的数据表明,随着 Elixhauser 合并症评分的增加,死亡率和预后不良的情况逐渐增加,这代表了患者术前的严重程度指数。我们的研究还发现,五个特征与患者年龄之间存在弱相关性。这些结果均表明,导致超高龄患者功能预后不良、围手术期并发症和死亡率的原因不是单纯的高龄,而是其他伴随因素。