Department of Geriatric Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.
Clin Interv Aging. 2021 Nov 19;16:1967-1974. doi: 10.2147/CIA.S333238. eCollection 2021.
Respiratory complication is one of the major challenges in the treatment of older adults with hip fractures. However, no study so far has investigated the effect of wearing medical masks on the prevention of perioperative respiratory complications in these patients.
In this retrospective cohort study, 1016 consecutive patients aged ≥65 years with hip fractures were included and assigned to two groups: the control group and the observation group. The two groups received the same perioperative management modalities. In addition, patients in the observation group were asked to wear medical masks for protection. Data of patients' demographics, fracture type, surgical methods, comorbidities, the incidence of perioperative respiratory and other complications, and hospital outcomes were collected and compared between the two groups. Subgroup analyses were also performed stratified by fracture types.
A total of 1016 patients (292 females and 724 males) with a mean age of 79.4±7.3 years were analyzed in the study, including 533 in the control group and 483 in the observation group. The overall incidence of perioperative respiratory complication, and the incidence of pulmonary infection, respiratory failure and arrhythmia in the observation group were significantly lower than the control group, especially in winter and spring. There was no difference in other complications, hospital length of stay, and total hospital costs. Further subgroup analyses showed that the incidence of heart failure and arrhythmia in the observation group was lower than that in the control group for patients with femoral neck fractures, which was different from patients with intertrochanteric fractures.
The incidence of perioperative respiratory complications, including pulmonary infection and respiratory failure, could be reduced in older adults with hip fractures by strengthening personal protection, including wearing medical masks, especially in winter and spring. Wearing medical masks could also effectively reduce the incidence of perioperative heart failure and arrhythmia in femoral neck fracture patients and do not increase the incidence of other complications and the burden of hospitalization.
呼吸并发症是治疗老年髋部骨折患者的主要挑战之一。然而，迄今为止尚无研究调查在这些患者中佩戴医用口罩对预防围手术期呼吸并发症的影响。
在这项回顾性队列研究中，纳入了 1016 例年龄≥65 岁的连续髋部骨折患者，并将其分为两组：对照组和观察组。两组患者均接受相同的围手术期管理方式。此外，观察组患者被要求佩戴医用口罩进行防护。收集并比较两组患者的人口统计学、骨折类型、手术方法、合并症、围手术期呼吸等并发症的发生率和住院结局。还按骨折类型进行了亚组分析。
本研究共分析了 1016 例患者（292 例女性和 724 例男性），平均年龄为 79.4±7.3 岁，其中对照组 533 例，观察组 483 例。观察组围手术期呼吸并发症总发生率及肺部感染、呼吸衰竭和心律失常发生率均显著低于对照组，尤其是在冬春季。两组其他并发症、住院时间和总住院费用无差异。进一步的亚组分析显示，对于股骨颈骨折患者，观察组心力衰竭和心律失常的发生率低于对照组，与转子间骨折患者不同。
通过加强个人防护，包括佩戴医用口罩，可降低髋部骨折老年患者围手术期呼吸并发症（包括肺部感染和呼吸衰竭）的发生率，尤其是在冬春季。佩戴医用口罩还可以有效降低股骨颈骨折患者围手术期心力衰竭和心律失常的发生率，且不会增加其他并发症的发生率和住院负担。
