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百岁老人髋部骨折的结局:系统评价和荟萃分析。

Outcomes of hip fracture in centenarians: a systematic review and meta-analysis.

机构信息

St George's University London, London, SW17 0RE, UK.

Medical University of Sofia, Sofia, 1431, Bulgaria.

出版信息

Eur Geriatr Med. 2023 Dec;14(6):1223-1239. doi: 10.1007/s41999-023-00866-y. Epub 2023 Oct 4.

Abstract

PURPOSE

Outcomes of hip fractures in centenarians remain underreported owing to the small number of patients reaching 100 years of age. This review aimed to determine outcomes of hip fracture in centenarians and to identify the most common comorbidities among centenarians with hip fracture to better characterise this population.

METHODS

Published and unpublished literature databases, conference proceedings and the reference lists of included studies were searched to the 25th of January 2023. A random-effects meta-analysis was performed. Included studies were appraised using tools respective of study design.

RESULTS

Twenty-three studies (6970 centenarians) were included (retrospective period: 1990-2020). The evidence was largely moderate to low in quality. One-year mortality following a hip fracture was 53.8% (95% CI 47.2 to 60.3%). Pooled complication rate following a hip fracture in centenarians was 50.5% (95% CI 25.3 to 75.6%). Dementia (26.2%, 95% CI 15.7 to 38.2%), hypertension (15.6%, 95% CI 3.4 to 33.1%), and diabetes (5.5%, 95% CI 1.9 to 10.7%) were the most common comorbidities among centenarians with hip fracture.

CONCLUSION

Hip fractures in centenarians typically involve complex patient presentations with diverse comorbidities. However, the current evidence-base is moderate to low in quality. Effective cross-discipline communication and intervention is suggested to promote treatment outcomes.

摘要

目的

由于达到 100 岁高龄的患者数量较少,百岁老人髋部骨折的结局仍报道不足。本综述旨在确定百岁老人髋部骨折的结局,并确定髋部骨折的百岁老人最常见的合并症,以便更好地描述这一人群。

方法

检索了截至 2023 年 1 月 25 日出版和未出版的文献数据库、会议记录以及纳入研究的参考文献列表。进行了随机效应荟萃分析。使用各自研究设计的工具对纳入的研究进行评估。

结果

共纳入 23 项研究(6970 名百岁老人)(回顾期:1990-2020 年)。证据质量主要为中低质量。髋部骨折后 1 年死亡率为 53.8%(95%CI 47.2-60.3%)。髋部骨折后百岁老人的并发症发生率为 50.5%(95%CI 25.3-75.6%)。髋部骨折的百岁老人最常见的合并症是痴呆(26.2%,95%CI 15.7-38.2%)、高血压(15.6%,95%CI 3.4-33.1%)和糖尿病(5.5%,95%CI 1.9-10.7%)。

结论

百岁老人髋部骨折通常涉及复杂的临床表现和多种合并症。然而,当前的证据质量为中低质量。建议进行有效的跨学科沟通和干预,以促进治疗结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6e9/10754761/5edbdba5bdfb/41999_2023_866_Fig1_HTML.jpg

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