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老年髋部骨折围手术期综合评估的效果。

Effectiveness of Perioperative Comprehensive Evaluation of Hip Fracture in the Elderly.

机构信息

Department of Trauma Orthopedics, General Hospital of Ningxia Medical University, Ningxia, China.

Ningxia Medical University, Yinchuan 750004, China.

出版信息

Comput Intell Neurosci. 2022 Aug 5;2022:4124354. doi: 10.1155/2022/4124354. eCollection 2022.

Abstract

OBJECTIVE

The objective is to observe the effect of Comprehensive Geriatric Assessment (CGA) in the perioperative period of hip fracture.

METHODS

From October 2018 to October 2021, 155 patients over the age of 65 diagnosed with hip fracture and treated with surgery at the Department of Trauma Orthopaedics of General Hospital of Ningxia Medical University were randomly divided into two groups using a prospective research method. A total of 70 cases in the CGA group received a perioperative comprehensive assessment of the geriatric, and 85 cases in the control group received routine medical consultation.

RESULTS

Elderly patients with hip fractures have a high comorbidity index. Patients with abnormal daily activity before injury accounted for 55%, the abnormal rate of nutrition was 58.1%, the abnormal rate of cognition, anxiety, and depression was 81.8%, and 77.3% of the patients were in a weak state. There was no significant difference in age, gender, ASA grade, fracture type, and operation mode between the two groups, but there were significant differences in operation rate at 48 h (  = 22.153;  ≤ 0.001), preoperative waiting time ( = -6.387;  ≤ 0.001), total hospital stay ( = -11.756;  ≤ 0.001), and incidence of postoperative delirium (  = 23.897;  ≤ 0.001).

CONCLUSIONS

The implementation of CGA shortened the preoperative waiting time and total hospital stay, increased the 48 h operation rate, and reduced the incidence of postoperative delirium.

摘要

目的

观察综合老年评估(CGA)在髋部骨折围手术期的效果。

方法

采用前瞻性研究方法,将 2018 年 10 月至 2021 年 10 月宁夏医科大学总医院创伤骨科收治的 155 例年龄>65 岁的髋部骨折患者随机分为两组。CGA 组 70 例患者接受围手术期全面老年评估,对照组 85 例患者接受常规医疗咨询。

结果

髋部骨折老年患者的合并症指数较高。受伤前日常生活活动异常者占 55%,营养异常率为 58.1%,认知、焦虑和抑郁异常率为 81.8%,77.3%的患者身体虚弱。两组患者在年龄、性别、ASA 分级、骨折类型和手术方式方面差异无统计学意义,但在 48 h 内手术率( = 22.153; ≤ 0.001)、术前等待时间( = -6.387; ≤ 0.001)、总住院时间( = -11.756; ≤ 0.001)和术后谵妄发生率( = 23.897; ≤ 0.001)方面差异有统计学意义。

结论

实施 CGA 可缩短术前等待时间和总住院时间,提高 48 h 内手术率,降低术后谵妄发生率。

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Reducing delirium after hip fracture: a randomized trial.降低髋部骨折后谵妄发生率:一项随机试验。
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[Clinical application of multidisciplinary team co-management in geriatric hip fractures].多学科团队共同管理在老年髋部骨折中的临床应用
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Oct 15;33(10):1276-1282. doi: 10.7507/1002-1892.201905017.

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