Department of Orthopaedic Surgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China.
Department of Orthopaedic Surgery, The Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
Orthop Surg. 2022 Oct;14(10):2462-2469. doi: 10.1111/os.13417. Epub 2022 Aug 26.
To explore the mortality of patients with fragile hip fractures and assess the death-associated risk factors.
A total of 690 patients with osteoporotic hip fractures (age, 50-103 years) that were treated from January 2010 to December 2015 were enrolled and followed-up in this study and the clinical data were retrospectively collected. Three months, 1 year, and the total mortality were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications. The mortality of each group was compared by chi-square test or corrected chi-square test for univariate analysis, and the factors with statistically significant mortality difference confirmed by univariate analysis were analyzed by binary logistic multivariate analysis.
The 3-month mortality was 7.69%, the 1-year mortality was 15.60%, and the total mortality of the follow-up time was 24.06%. The 1-year and total mortality during the follow-up of the patients were higher in the >75-year-old group than those in the ≤75-year-old group (p = 0.000, respectively); were higher in the male patients than that in the female patients (p = 0.042; p = 0.017, respectively); were significantly lower in the operation group than that in the non-operation group (p = 0.000, respectively); were significantly lower in the patients that underwent the operation in ≤5 days than the patients that underwent the operation within >5 days (p = 0.008; p = 0.000, respectively); were significantly lower in patients with >2 kinds of combined medical diseases than those with ≥2 kinds of chronic diseases (p = 0.000, respectively); were significantly lower in patients receiving anti-osteoporosis treatment than in patients not receiving anti-osteoporosis treatment (p = 0.000, p = 0.002, respectively). Binary logistic regression analysis showed that the independent risk factors affecting mortality included advanced age >75-years-old (OR = 5.653, p = 0.000), male (OR = 1.998, p = 0.001), non-surgical treatment (OR = 9.909, p = 0.000), the number of combined medical diseases ≥2 (OR = 1.522, p = 0.042), and non-anti-osteoporosis treatment (OR = 1.796, p = 0.002).
Age, whether or not surgical treatment was performed, the number of medical diseases, and whether or not anti-osteoporosis treatment was performed were independent risk factors for 3-month and 1-year mortality in patients with fragile hip fractures.
探讨髋部脆性骨折患者的死亡率，并评估与死亡相关的危险因素。
回顾性分析 2010 年 1 月至 2015 年 12 月收治的 690 例骨质疏松性髋部骨折患者（年龄 50-103 岁）的临床资料，随访并记录患者的一般资料。采用 χ²检验或校正 χ²检验进行单因素分析，对有统计学差异的单因素进行二元 Logistic 多因素分析。
患者 3 个月的死亡率为 7.69%，1 年的死亡率为 15.60%，随访期间的总死亡率为 24.06%。>75 岁组患者 1 年和总死亡率均高于≤75 岁组（p=0.000）；男性患者的死亡率均高于女性患者（p=0.042，p=0.017）；手术组患者的死亡率均低于非手术组（p=0.000）；伤后 5 d 内手术患者的死亡率均低于伤后 5 d 以上手术患者（p=0.008，p=0.000）；合并>2 种合并症的患者死亡率均高于合并≥2 种慢性病的患者（p=0.000）；接受抗骨质疏松治疗的患者死亡率均低于未接受抗骨质疏松治疗的患者（p=0.000，p=0.002）。二元 Logistic 回归分析显示，影响死亡率的独立危险因素包括年龄>75 岁（OR=5.653，p=0.000）、男性（OR=1.998，p=0.001）、非手术治疗（OR=9.909，p=0.000）、合并症≥2 种（OR=1.522，p=0.042）和未接受抗骨质疏松治疗（OR=1.796，p=0.002）。
年龄、是否手术治疗、合并症数量和是否抗骨质疏松治疗是髋部脆性骨折患者 3 个月和 1 年死亡率的独立危险因素。
