老年髋部骨折合并偏瘫患者的手术疗效分析。
Analysis of the Surgical Outcomes in Elderly Patients with Hip Fractures Combined with Hemiplegia.
机构信息
Department of Emergency, Air Force Characteristic Medical Center, Beijing, 100142, People's Republic of China.
Department of Orthopaedics, Air Force Characteristic Medical Center, Beijing, 100142, People's Republic of China.
出版信息
Clin Interv Aging. 2022 Jul 15;17:1093-1098. doi: 10.2147/CIA.S365576. eCollection 2022.
OBJECTIVE
This study aimed to investigate the surgical outcomes in elderly (age ≥65) patients with hip fractures combined with hemiplegia and compare them with the surgical outcomes in elderly patients with hip fractures but no hemiplegia.
METHODS
A total of 761 elderly patients with hip fractures who were treated between January 2013 and December 2019 were enrolled in this study using a retrospective study design. The patients were divided into two groups: a hemiplegia group (77 cases, 10.1%) and a non-hemiplegia group (684 cases, 89.9%). Length of hospital stay, postoperative complications, 30-day and one-year mortalities, and one-year functional status were compared between the two groups.
RESULTS
The average length of hospital stay in the hemiplegia group (13.51 ± 10.17 days) was longer than in the non-hemiplegia group (12.60 ± 7.83 days), but the difference was not statistically significant (P = 0.354). The incidence of postoperative complications in patients with hemiplegia (28.6%, 22/77) was higher than in patients without hemiplegia (15.4%, 105/684), and the difference was statistically significant (P = 0.003). The 30-day and one-year mortalities in the hemiplegia group were higher than in the non-hemiplegia group (30 days after surgery: 10.4%, 8/77 vs 4.5%, 31/684; one year after surgery: 29.9%, 23/77 vs 15.2%, 104/684), and the difference was statistically significant (30 days after surgery: P = 0.027; one year after surgery: P = 0.001). One year after surgery, the average activity of daily living score was 56.02 ± 9.63 in the hemiplegia group and 76.89 ± 8.40 in the non-hemiplegia group, and the difference was statistically significant (P = 0.000).
CONCLUSION
Hemiplegia can increase the incidence of postoperative complications and 30-day and one-year mortalities in patients with hip fractures.
目的
本研究旨在探讨伴有偏瘫的老年（≥65 岁）髋部骨折患者的手术结果，并与无偏瘫的老年髋部骨折患者的手术结果进行比较。
方法
采用回顾性研究设计，纳入 2013 年 1 月至 2019 年 12 月间收治的 761 例老年髋部骨折患者。将患者分为偏瘫组（77 例，10.1%）和非偏瘫组（684 例，89.9%）。比较两组患者的住院时间、术后并发症、30 天和 1 年死亡率以及 1 年功能状态。
结果
偏瘫组患者的平均住院时间（13.51±10.17 天）长于非偏瘫组（12.60±7.83 天），但差异无统计学意义（P=0.354）。偏瘫患者（28.6%，22/77）术后并发症发生率高于无偏瘫患者（15.4%，105/684），差异有统计学意义（P=0.003）。偏瘫组患者的 30 天和 1 年死亡率均高于非偏瘫组（术后 30 天：10.4%，8/77 比 4.5%，31/684；术后 1 年：29.9%，23/77 比 15.2%，104/684），差异有统计学意义（术后 30 天：P=0.027；术后 1 年：P=0.001）。术后 1 年，偏瘫组患者的日常生活活动评分平均为 56.02±9.63，非偏瘫组患者的平均为 76.89±8.40，差异有统计学意义（P=0.000）。
结论
偏瘫会增加髋部骨折患者术后并发症和 30 天及 1 年死亡率的发生。
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