马耳他的髋部骨折:手术延迟会影响临床结果吗?
Hip Fractures in Malta: Does Delay in Surgery Affect Clinical Outcomes?
作者信息
Muscat Kyle
机构信息
Surgery, Mater Dei Hospital, Msida, MLT.
出版信息
Cureus. 2024 Dec 10;16(12):e75467. doi: 10.7759/cureus.75467. eCollection 2024 Dec.
INTRODUCTION
Hip fractures are common and are a major cause of significant morbidity and mortality in the elderly population, particularly when treatment is delayed. The British Orthopaedic Association's (BOA) guidelines state that surgical treatment should be performed within 36 hours of admission. This study aimed to investigate the effects of delays in surgery on clinical outcomes and to evaluate mortality rates over a three-year follow-up period following proximal femoral fractures.
METHODOLOGY
This was a single-center, retrospective observational study of all patients aged ≥60 years admitted with low-energy hip fractures between June 1, 2020, and November 30, 2020. A total of 205 patients were included and followed up for three years. Data were collected from electronic medical records and operating theater notes. Statistical analysis was performed to analyze the effects of delay in surgery on clinical outcomes.
RESULTS
A 45.9% all-cause mortality rate was observed at three years post-hip fracture in this study. A delay of more than 36 hours to surgery was associated with a statistically significant increase in both length of hospital stay and mortality at one and three years, while no difference was observed in hip-related complications.
CONCLUSIONS
The three-year mortality rate compares well with those found in the literature. A delay in the surgical management of hip fractures is associated with overall worse clinical outcomes, with a higher mortality rate at three years.
引言
髋部骨折很常见,是老年人群发病和死亡的主要原因,尤其是治疗延迟时。英国骨科协会(BOA)的指南指出,手术治疗应在入院后36小时内进行。本研究旨在调查手术延迟对临床结局的影响,并评估股骨近端骨折后三年随访期内的死亡率。
方法
这是一项单中心回顾性观察研究,研究对象为2020年6月1日至2020年11月30日期间收治的所有年龄≥60岁的低能量髋部骨折患者。共纳入205例患者并进行了三年的随访。数据从电子病历和手术室记录中收集。进行统计分析以分析手术延迟对临床结局的影响。
结果
本研究中,髋部骨折后三年观察到的全因死亡率为45.9%。手术延迟超过36小时与住院时间延长以及1年和3年时的死亡率在统计学上显著增加相关,而髋部相关并发症未见差异。
结论
三年死亡率与文献中的结果相当。髋部骨折手术治疗延迟与总体较差的临床结局相关,三年时死亡率更高。