Tangchitphisut Paween, Khorana Jiraporn, Phinyo Phichayut, Patumanond Jayanton, Rojanasthien Sattaya, Apivatthakakul Theerachai
Department of Orthopaedics, School of Medicine, Mae Fah Luang University, Chiang Rai 57100, Thailand.
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Int J Environ Res Public Health. 2022 Mar 28;19(7):3992. doi: 10.3390/ijerph19073992.
An inability to bear self-weight is one of the unfavorable results in geriatric hip fracture, which needs to be prevented. This study determines pre-operative, intra-operative, and post-operative prognostic factors of the inability to bear self-weight at discharge in patients with fragility femoral neck fracture. This retrospective study was conducted at Chiang Mai University (CMU) hospital with an observational cohort design. Electronic medical records of patients aged ≥ 50 years old with fragility femoral neck fractures between 1 January 2015 and 31 December 2019 were reviewed. Pre-, intra-, and post-operative factors were collected. Ambulation status at discharge time was classified into either ability or inability to bear self-weight. Analysis of prognostic factors was done using multivariable risk ratio regression. In total, 269 patients were recruited in this study. Significantly prognostic factors of inability to bear self-weight at discharge were end-stage renal disease (ESRD), cirrhosis, cerebrovascular disease, pre-fracture ambulatory status, having associated fractures, increasing intra-operative blood loss, and having pressure sore. These prognostic factors could be used to predict patients' outcomes at discharge. Proper management could then be offered to the patients by the multidisciplinary care team to enhance surgical outcomes.
无法承受自身重量是老年髋部骨折的不良后果之一，需要加以预防。本研究确定了股骨颈脆性骨折患者出院时无法承受自身重量的术前、术中和术后预后因素。这项回顾性研究在清迈大学（CMU）医院进行，采用观察性队列设计。回顾了2015年1月1日至2019年12月31日期间年龄≥50岁的股骨颈脆性骨折患者的电子病历。收集了术前、术中和术后因素。出院时的行走状态分为能够承受自身重量或无法承受自身重量。使用多变量风险比回归分析预后因素。本研究共纳入269例患者。出院时无法承受自身重量的显著预后因素为终末期肾病（ESRD）、肝硬化、脑血管疾病、骨折前行走状态、合并骨折、术中失血量增加和有压疮。这些预后因素可用于预测患者出院时的结局。然后，多学科护理团队可以为患者提供适当的管理，以提高手术效果。
