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回顾性多中心(TRON 组)研究肱骨干脆弱性骨折:死亡率和危险因素分析。

Retrospective multicenter (TRON group) study of humeral shaft fragility fractures: Analysis of mortality rates and risk factors.

机构信息

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Injury. 2023 Aug;54(8):110855. doi: 10.1016/j.injury.2023.110855. Epub 2023 Jun 2.

Abstract

AIMS

This study aimed to show the mortality rate following humeral shaft fragility fractures (HSFF) in the elderly. The secondary aim was to examine the predictors associated with mortality in elderly patients who have sustained HSFF.

METHODS

From 2011 to 2020, all elderly patients aged 65 years and older with HSFF managed at our nine hospitals were retrospectively identified from our TRON database. Patient demographics and surgical characteristics were extracted from medical records and radiographs, and multivariable Cox regression analysis was used to identify factors affecting mortality.

RESULTS

In total, 153 patients who sustained HSFF were included. The mortality rate for HSFF in the elderly was 15.7% at 1 year and 24.6% at 2 years. Multivariable Cox regression analysis showed significant differences in survival for the following variables: older age (p < 0.001), underweight (p = 0.022), severely ill (p = 0.025), mobility limited to indoors (p = 0.003), dominant-side injury (p = 0.027), and nonoperative treatment (p = 0.013).

CONCLUSION

The outcome following HSFF in the elderly population appears to be relatively grim. The prognosis of elderly patients with HSFF is closely related to their medical history. In the elderly patients with HSFF, operative treatment should be positively considered while taking into account their medical status.

摘要

目的

本研究旨在展示老年人肱骨干脆弱性骨折(HSFF)后的死亡率。次要目的是检查与发生 HSFF 的老年患者死亡相关的预测因素。

方法

从 2011 年至 2020 年,从我们的 TRON 数据库中回顾性地确定了在我们的 9 家医院接受治疗的所有年龄在 65 岁及以上的老年 HSFF 患者。从病历和 X 光片中提取患者人口统计学和手术特征,并使用多变量 Cox 回归分析来确定影响死亡率的因素。

结果

共纳入 153 例发生 HSFF 的患者。老年人 HSFF 的 1 年死亡率为 15.7%,2 年死亡率为 24.6%。多变量 Cox 回归分析显示,以下变量的生存率存在显著差异:年龄较大(p<0.001)、体重不足(p=0.022)、病情严重(p=0.025)、活动受限室内(p=0.003)、优势侧损伤(p=0.027)和非手术治疗(p=0.013)。

结论

老年人 HSFF 后的结果似乎相对严峻。HSFF 老年患者的预后与其病史密切相关。在老年 HSFF 患者中,在考虑其身体状况的同时,应积极考虑手术治疗。

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