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老年患者髋部骨折早期手术后2年的死亡率概况

Mortality profile after 2 years of hip fractures in elderly patients treated with early surgery.

作者信息

Raichandani Kishore, Agarwal Shubham, Jain Hemant, Bharwani Nandlal

机构信息

Department of Orthopaedics, Dr SN Medical College, Jodhpur, India.

出版信息

J Clin Orthop Trauma. 2021 Apr 15;18:1-5. doi: 10.1016/j.jcot.2021.04.009. eCollection 2021 Jul.

Abstract

BACKGROUND

In geriatric age group, hip fractures tend to become a major public health hazard. Due to this high occurrence, there is a need to develop standardized, effective, and multidisciplinary management for treatment. These elderly patients have excessive mortality that can extend ahead of the time of recovery. Early surgery after hip fractures has lead to a notable reduction in mortality rates. Still, it is considerably high as compared to other fractures.

METHODS

266 patients of >65 years who were operated within 72 h hours in a tertiary level health care centre for hip fractures were included. They were evaluated with X-rays and grade of Singh's index was noted. Mortality rates and the factors associated with it such as age, sex, co morbidities (using Charlson's co morbidity Index/CCI) were evaluated after 2 year follow up.

RESULTS

The overall 2-year mortality reported in our study population was 11.2%. It was broadly lower as compared to most of the other studies. It was 6.3% in females as compared to 18.1% in males. While it was reported to be only 6% in 65-74 years of age, it was 25% in patients who were 85 years and above. 76.6% of the patients had Singh's index of ≤ grade 3 showing osteoporosis. The patients with Low Charlson's score showed only 4.2% mortality while those with high Charlson's score showed 25.5% mortality.

CONCLUSION

It was concluded that Mortality among elderly patients after early surgery after osteoporotic hip fractures is quite significant. The factors for improvement in long term survival post-hip fracture may include changing treatment patterns, increasing life expectancy and early surgery. Increase in age, female sex, and high CCI Scores were major risk factors of mortality after hip fractures in a 2-year follow-up period.

摘要

背景

在老年人群体中,髋部骨折往往成为一项重大的公共卫生危害。鉴于其高发生率,有必要制定标准化、有效且多学科的治疗管理方案。这些老年患者的死亡率过高,且可能在康复之前就持续存在。髋部骨折后早期手术已使死亡率显著降低。不过,与其他骨折相比,其死亡率仍相当高。

方法

纳入在一家三级医疗保健中心于72小时内接受髋部骨折手术的266例65岁以上患者。对他们进行X线检查并记录辛格指数分级。在2年随访后评估死亡率以及与之相关的因素,如年龄、性别、合并症(使用查尔森合并症指数/CCI)。

结果

我们研究人群中报告的总体2年死亡率为11.2%。与大多数其他研究相比,该死亡率普遍较低。女性为6.3%,男性为18.1%。65至74岁的患者死亡率仅为6%,而85岁及以上患者的死亡率为25%。76.6%的患者辛格指数≤3级,显示患有骨质疏松症。查尔森评分低的患者死亡率仅为4.2%,而查尔森评分高的患者死亡率为25.5%。

结论

得出的结论是,骨质疏松性髋部骨折后老年患者早期手术后的死亡率相当高。髋部骨折后长期生存改善的因素可能包括改变治疗模式、延长预期寿命和早期手术。年龄增加、女性性别以及高CCI评分是2年随访期内髋部骨折后死亡的主要危险因素。

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