Pettit Christopher J, Herbosa Carolyn F, Ganta Abhishek, Rivero Steven, Tejwani Nirmal, Leucht Philipp, Konda Sanjit R, Egol Kenneth A
Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and.
Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY.
J Orthop Trauma. 2025 Jan 1;39(1):8-13. doi: 10.1097/BOT.0000000000002909.
To determine which in-hospital complications after the operative treatment of hip fractures are associated with increased in-patient, 30-day, and 1-year mortality.
Retrospective study.
A single academic medical center and a Level 1 Trauma Center.
All patients who were operatively treated for hip fractures (Orthopaedic Trauma Association/AO 31A, 31B and Vancouver A, B, and C periprosthetic fractures) at a single center between October, 2014, and June, 2023.
Occurrence of an in-hospital complication was recorded. Cohorts were based on mortality time points (during admission, 30 days, and 1 year) and compared with patients who were alive at those time points to determine which in-hospital complications were most associated with mortality. Correlation analysis was performed between patients who died and those who were alive at each time point.
A total of 3134 patients (average age of 79.6 years, range 18-104 years and 66.6% women) met inclusion for this study. The overall mortality rate during admission, 30 days, and 1 year was found to be 1.6%, 3.9%, and 11.1%, respectively. Sepsis was the complication most associated with increased in-hospital mortality (odds ratio [OR] 7.79, 95% confidence interval [CI], 3.22-18.82, P < 0.001) compared with other in-hospital complications. Compared with other in-hospital complications, stroke was the complication most associated with 30-day mortality (OR 7.95, 95% CI, 1.82-34.68, P < 0.001). Myocardial infarction was the complication most associated with 1-year mortality (OR 2.86, 95% CI, 1.21-6.77, P = 0.017) compared with other in-hospital complications.
Postoperative sepsis, stroke, and myocardial infraction were the 3 complications most associated with mortality during admission, 30-day mortality, and 1-year mortality, respectively, during the operative treatment of hip fractures.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
确定髋部骨折手术治疗后的哪些院内并发症与住院期间、30天及1年死亡率增加相关。
回顾性研究。
一家学术医疗中心和一级创伤中心。
2014年10月至2023年6月期间在单一中心接受髋部骨折手术治疗的所有患者（骨科创伤协会/AO 31A、31B型以及温哥华A、B、C型假体周围骨折）。
记录院内并发症的发生情况。根据死亡时间点（住院期间、30天和1年）对队列进行分组，并与在这些时间点存活的患者进行比较，以确定哪些院内并发症与死亡率最相关。对每个时间点死亡和存活的患者进行相关性分析。
共有3134例患者（平均年龄79.6岁，年龄范围18 - 104岁，女性占66.6%）符合本研究纳入标准。发现住院期间、30天和1年的总体死亡率分别为1.6%、3.9%和11.1%。与其他院内并发症相比，脓毒症是与院内死亡率增加最相关的并发症（比值比[OR] 7.79，95%置信区间[CI]，3.22 - 18.82，P < 0.001）。与其他院内并发症相比，中风是与30天死亡率最相关的并发症（OR 7.95，95% CI，1.82 - 34.68，P < 0.001）。与其他院内并发症相比，心肌梗死是与1年死亡率最相关的并发症（OR 2.86，95% CI，1.21 - 6.77，P = 0.017）。
术后脓毒症、中风和心肌梗死分别是髋部骨折手术治疗期间住院期间死亡率、30天死亡率和1年死亡率最相关的3种并发症。
预后III级。有关证据水平的完整描述，请参阅作者指南。
