Department of Orthopedics, Wuhan Fourth Hospital, Wuhan Orthopedic Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
PLoS One. 2022 Aug 23;17(8):e0273350. doi: 10.1371/journal.pone.0273350. eCollection 2022.
Postoperative pneumonia is a serious complication in elderly patients with hip fracture. It is necessary to identify the influencing factors of postoperative pneumonia in patients with hip fracture.
Elderly patients with hip fractures admitted to a tertiary hospital in China from January 1, 2020 to August 31, 2021 were included. The characteristics of patients with and without postoperative pneumonia were evaluated and compared. Logistic multivariate regression analyses were conducted to assess the risk factors of postoperative pneumonia.
267 patients with hip fracture were included, the incidence of postoperative pneumonia in patients with hip fracture was 13.11%. There were significant differences in the age, diabetes mellitus, anemia, hypoalbuminemia, anesthesia method and duration of surgery between infection and no infection group, no significant differences in the gender, BMI, hypertension, hyperlipidemia, type of fracture, preoperative oxygen saturation, white blood cell count, platelet count, red blood cell count, creatinine, alanine aminotransferase, aspartate aminotransferase, estimated blood loss during surgery were detected between infection and no infection group. Logistic regression analysis showed that age≥70y (OR2.326, 95%CI1.2483.129), diabetes mellitus (OR2.123, 95%CI1.0213.551), anemia (OR3.199,95%CI1.9435.024), hypoalbuminemia (OR2.377, 95%CI1.2113.398), general anesthesia (OR1.947, 95%CI1.1153.038), duration of surgery≥120min (OR1.621, 95%CI1.4882.534) were the risk factors of postoperative pneumonia in elderly patients with hip fracture (all p<0.05). Escherichia Coli (33.33%), Klebsiella pneumoniae (28.57%), Staphylococcus aureus (21.43%) were the most common bacteria of pulmonary infection.
There are many risk factors for postoperative pneumonia in elderly patients with hip fractures after surgery. In clinical practice, medical workers should take targeted interventions for those risk factors to reduce postoperative pneumonia.
术后肺炎是老年髋部骨折患者的一种严重并发症。有必要确定髋部骨折患者术后肺炎的影响因素。
纳入 2020 年 1 月 1 日至 2021 年 8 月 31 日在中国一家三级医院住院的老年髋部骨折患者。评估并比较了发生和未发生术后肺炎患者的特征。采用多因素 logistic 回归分析评估术后肺炎的危险因素。
共纳入 267 例髋部骨折患者，髋部骨折患者术后肺炎发生率为 13.11%。感染组与未感染组在年龄、糖尿病、贫血、低蛋白血症、麻醉方式和手术时间方面有显著差异，而在性别、BMI、高血压、高血脂、骨折类型、术前血氧饱和度、白细胞计数、血小板计数、红细胞计数、肌酐、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、手术期间估计失血量方面无显著差异。logistic 回归分析显示，年龄≥70y（OR2.326，95%CI1.2483.129）、糖尿病（OR2.123，95%CI1.0213.551）、贫血（OR3.199，95%CI1.9435.024）、低蛋白血症（OR2.377，95%CI1.2113.398）、全身麻醉（OR1.947，95%CI1.1153.038）、手术时间≥120min（OR1.621，95%CI1.4882.534）是老年髋部骨折患者术后发生肺炎的危险因素（均 P<0.05）。引起肺部感染的最常见细菌依次为大肠埃希菌（33.33%）、肺炎克雷伯菌（28.57%）、金黄色葡萄球菌（21.43%）。
老年髋部骨折患者术后发生术后肺炎的危险因素较多。在临床实践中，医务人员应针对这些危险因素采取有针对性的干预措施，以降低术后肺炎的发生。
