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老年患者手术治疗髋部骨折后肺炎的发病率及危险因素:一项回顾性队列研究

Incidence and risk factors for postoperative pneumonia following surgically treated hip fracture in geriatric patients: a retrospective cohort study.

作者信息

Tian Yunxu, Zhu Yanbin, Zhang Kexin, Tian Miao, Qin Shuhui, Li Xiuting, Zhang Yingze

机构信息

Department of Orthopaedic Surgery, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, People's Republic of China.

Hebei Bone Research Institute, Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.

出版信息

J Orthop Surg Res. 2022 Mar 24;17(1):179. doi: 10.1186/s13018-022-03071-y.

Abstract

OBJECTIVE

Large sample investigations for risk factors for pneumonia in elderly patients after hip fracture surgeries are lacking. The purpose of this study is to determine the incidence and risk factors for postoperative pneumonia in geriatric patients following hip fracture operations.

METHODS

A retrospective study of incidence and risk factors in a tertiary referral center between 2016 and 2020 was conducted. Geriatric patients who developed postoperative pneumonia after surgeries of hip fracture during hospitalization stay were defined as cases and those without as controls. Multivariate logistic regression model was used to evaluate risk factors for postoperative pneumonia.

RESULTS

This study included 3147 patients, and 182 developed postoperative pneumonia, denoting the rate of 5.8%. In the multivariate analyses, age (OR 1.04; 95% CI 1.02-1.06), sex (males) (OR 2.27; 95% CI 1.64-3.13), respiratory disease (OR 3.74; 95% CI 2.32-6.04), heart disease (OR 1.68; 95% CI 1.14-2.47), cerebrovascular disease (OR 1.58; 95% CI 1.11-2.27), liver disease (OR 2.61; 95% CI 1.33-5.15), preoperative stay (OR 1.08; 95% CI 1.05-1.11) and general anesthesia (OR 1.61; 95% CI 1.15-2.27) were identified as independent risk factors for postoperative pneumonia.

CONCLUSIONS

This study identified several risk factors for pneumonia in geriatric patients after hip fracture operations, providing a viable preventive strategy for optimizing clinical conditions for reduction of postoperative pneumonia.

摘要

目的

缺乏针对老年髋部骨折手术后肺炎危险因素的大样本调查。本研究旨在确定老年患者髋部骨折手术后肺炎的发病率及危险因素。

方法

对一家三级转诊中心2016年至2020年期间的发病率及危险因素进行回顾性研究。将住院期间髋部骨折手术后发生术后肺炎的老年患者定义为病例组,未发生的定义为对照组。采用多因素logistic回归模型评估术后肺炎的危险因素。

结果

本研究纳入3147例患者,其中182例发生术后肺炎,发生率为5.8%。多因素分析显示,年龄(OR 1.04;95%CI 1.02-1.06)、性别(男性)(OR 2.27;95%CI 1.64-3.13)、呼吸系统疾病(OR 3.74;95%CI 2.32-6.04)、心脏病(OR 1.68;95%CI 1.14-2.47)、脑血管疾病(OR 1.58;95%CI 1.11-2.27)、肝脏疾病(OR 2.61;95%CI 1.33-5.15)、术前住院时间(OR 1.08;95%CI 1.05-1.11)及全身麻醉(OR 1.61;95%CI 1.15-2.27)被确定为术后肺炎的独立危险因素。

结论

本研究确定了老年髋部骨折手术后肺炎的几个危险因素,为优化临床条件以降低术后肺炎提供了可行的预防策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/965b/8944015/86424eaf6088/13018_2022_3071_Fig1_HTML.jpg

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