Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
BMC Musculoskelet Disord. 2024 Aug 10;25(1):636. doi: 10.1186/s12891-024-07753-y.
Data are currently lacking regarding perioperative stroke recurrence in hip fracture patients with previous stroke. We aimed to analyze the incidence and risk factors of perioperative stroke recurrence in elderly patients with previous stroke who underwent hip fracture surgery.
We used 2019 and 2020 data from the United States National Inpatient Sample database. We identified elderly patients with previous ischemic stroke who had undergone hip fracture surgery to analyze the incidence of stroke recurrence. A 1:4 propensity score matching was used to balance confounding factors related to demographic data and matched the control group with the stroke recurrence group. Risk factors for stroke recurrence were determined using univariate and multivariate logistic analysis.
The incidence of perioperative stroke recurrence in elderly patients with previous stroke who underwent hip fracture surgery was 5.7% (51/882). Multivariate logistic regression analysis showed that intertrochanteric fracture (odds ratio 2.24, 95% confidence interval 1.14-4.57; p = 0.021), hypertension (odds ratio 2.49, 95% confidence interval 1.26-5.02; p = 0.009), and postoperative pneumonia (odds ratio 4.35, 95% confidence interval 1.59-11.82; p = 0.004) were independently associated with stroke recurrence.
The perioperative stroke recurrence rate in elderly hip fracture patients with previous stroke was 5.7%. Intertrochanteric fracture, hypertension, and postoperative pneumonia were identified as factors significantly associated with stroke recurrence in this study. Adequate systemic support post-fracture, effective blood pressure management, and proactive infection prevention may help reduce stroke recurrence, especially in patients with intertrochanteric fractures.
目前缺乏关于既往卒中的髋部骨折患者围手术期卒中复发的数据。我们旨在分析既往卒中行髋部骨折手术的老年患者围手术期卒中复发的发生率和危险因素。
我们使用了美国国家住院患者样本数据库 2019 年和 2020 年的数据。我们确定了既往发生缺血性卒中且行髋部骨折手术的老年患者，以分析卒中复发的发生率。采用 1:4 倾向评分匹配法平衡与人口统计学数据相关的混杂因素，并将对照组与卒中复发组相匹配。采用单因素和多因素逻辑回归分析确定卒中复发的危险因素。
既往卒中行髋部骨折手术的老年患者围手术期卒中复发的发生率为 5.7%（51/882）。多因素逻辑回归分析显示，转子间骨折（比值比 2.24，95%置信区间 1.14-4.57；p=0.021）、高血压（比值比 2.49，95%置信区间 1.26-5.02；p=0.009）和术后肺炎（比值比 4.35，95%置信区间 1.59-11.82；p=0.004）与卒中复发独立相关。
既往卒中的老年髋部骨折患者围手术期卒中复发率为 5.7%。转子间骨折、高血压和术后肺炎是本研究中与卒中复发显著相关的因素。骨折后充分的全身支持、有效的血压管理和积极的感染预防可能有助于降低卒中复发率，尤其是在转子间骨折患者中。
