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90岁以上接受手术治疗的股骨近端骨折患者的死亡率

MORTALITY IN PATIENTS > 90 YEARS OLD WITH PROXIMAL FEMORAL FRACTURES SUBJECTED TO SURGERY.

作者信息

Oliveira Carlos Eduardo Nunes DE, Feitosa André Coelho Citó, Falótico Guilherme Guadagnini, Ferreira Gabriel Ferraz, Durigon Thomas Stravinskas, Arliani Gustavo Gonçalves

机构信息

Prevent Senior, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2022 Aug 26;30(4):e255534. doi: 10.1590/1413-785220223004e255534. eCollection 2022.

Abstract

INTRODUCTION

Proximal femoral fractures have a high mortality rate among older adults, especially those aged > 80 years.

OBJECTIVE

To analyze predictive factors for hospital or late mortality of patients > 90 years old who showed proximal femoral fracture and subjected to surgery.

METHODS

The study included data from 230 patients aged > 90 years diagnosed with proximal femoral fracture and who underwent surgery between January and December 2017. The statistical evaluation was performed by multivariate analysis by a logistic regression. The associations were estimated by the odds ratio (OD) and confidence interval (95%). Statistical significance was determined with p < 0.05.

RESULTS

Late death occurred in 51.3% (118 patients) of the sample and hospital death in 3.5% (8 patients). Most patients were women (83.5%) and the most common fracture was transtrochanteric (57.0%). There was association between late death and the surgery duration (p < 0.05), and between hospital death and the presence of heart diseases (p < 0.05) or endocrinopathies (p < 0.05).

CONCLUSION

Most patients aged > 90 years with proximal femoral fracture subjected to surgery died in less than one year. Late death was associated with the surgery duration and hospital death was associated with the presence of previous endocrinopathies or heart diseases, and the female gender was a protective factor from this outcome.

摘要

引言

股骨近端骨折在老年人中死亡率较高,尤其是年龄大于80岁的老年人。

目的

分析年龄大于90岁且接受手术治疗的股骨近端骨折患者的医院死亡率或晚期死亡率的预测因素。

方法

该研究纳入了2017年1月至12月期间诊断为股骨近端骨折且接受手术治疗的230例年龄大于90岁患者的数据。通过逻辑回归进行多变量分析进行统计评估。通过比值比(OD)和置信区间(95%)估计关联。以p < 0.05确定统计学显著性。

结果

样本中51.3%(118例患者)发生晚期死亡,3.5%(8例患者)发生医院死亡。大多数患者为女性(83.5%),最常见的骨折类型是转子间骨折(57.0%)。晚期死亡与手术时间有关(p < 0.05),医院死亡与心脏病(p < 0.05)或内分泌疾病(p < 0.05)的存在有关。

结论

大多数年龄大于90岁且接受手术治疗的股骨近端骨折患者在不到一年的时间内死亡。晚期死亡与手术时间有关,医院死亡与既往内分泌疾病或心脏病的存在有关,女性性别是该结果的保护因素。

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Nonagenarian hip fractures: Morbidity and mortality at a single institution.九旬老人髋部骨折:单机构的发病率和死亡率
J Clin Orthop Trauma. 2020 Sep 22;14:69-73. doi: 10.1016/j.jcot.2020.09.020. eCollection 2021 Mar.
10
Mortality after hip fractures in nonagenarians.百岁老人髋部骨折后的死亡率。
J Bone Metab. 2012 Nov;19(2):83-6. doi: 10.11005/jbm.2012.19.2.83. Epub 2012 Nov 16.

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