Lu Panpan, Xie Tian, Dai Guangchun, Li Yingjuan, Zou Jihong, Chen Hui, Rui Yunfeng
Department of Orthopedic Trauma, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China;Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China;Trauma Center, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China;Orthopaedic Trauma Institute of Southeast University, Nanjing Jiangsu, 210009, P.R.China;School of Medicine, Southeast University, Nanjing Jiangsu, 210009, P.R.China.
Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China;School of Medicine, Southeast University, Nanjing Jiangsu, 210009, P.R.China;Department of Geriatrics, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Feb 15;35(2):217-220. doi: 10.7507/1002-1892.202009122.
To analyze the risk factors for postoperative mortality of the elderly patients with femoral neck fracture undergoing hemiarthroplasty.
Patients who underwent hemiarthroplasty for femoral neck fractures between January 2011 and December 2015 were enrolled as object. One hundred and nine patients who met the selection criteria were included in the study, and the clinical data were collected, including gender, age, time from admission to surgery, comorbidities, and preoperative hemoglobin level and nutritional status. Univariate analysis and Cox proportional hazard regression model were used to screen the risk factors for postoperative mortality.
The 1-year and 2-year mortalities were 6.4% (7/109) and 17.4% (19/109), respectively. Univariate analysis showed that the age, preoperative hemoglobin level and nutritional status were the influencing factors of postoperative mortality in the elderly patients with femoral neck fractures treated with hemiarthroplasty ( <0.05). Multivariate analysis showed that the age≥80 years and malnutrition were the independent risk factors for postoperative mortality ( <0.05).
To improve the clinical outcomes, perioperative risk should be comprehensively evaluated by multidisciplinary and perioperative management should be strengthened in the elderly patients with femoral neck fracture, especially those with advanced age and malnutrition, for the high postoperative mortality.
分析老年股骨颈骨折患者行半髋关节置换术后的死亡危险因素。
选取2011年1月至2015年12月期间因股骨颈骨折行半髋关节置换术的患者作为研究对象。纳入符合入选标准的109例患者，收集其临床资料，包括性别、年龄、入院至手术时间、合并症、术前血红蛋白水平及营养状况。采用单因素分析和Cox比例风险回归模型筛选术后死亡的危险因素。
1年和2年死亡率分别为6.4%（7/109）和17.4%（19/109）。单因素分析显示，年龄、术前血红蛋白水平及营养状况是老年股骨颈骨折行半髋关节置换术患者术后死亡的影响因素（P<0.05）。多因素分析显示，年龄≥80岁及营养不良是术后死亡的独立危险因素（P<0.05）。
为改善临床结局，对于术后死亡率较高的老年股骨颈骨折患者，尤其是高龄和营养不良患者，应多学科综合评估围手术期风险并加强围手术期管理。
