Wang Tao, Long Yubin, Wang Zhiqian, Hou Zhiyong
Department of Lower Limb Trauma, Beijing Jishuitan Hospital, Guizhou Hospital, Baiyun District, Guiyang, Guizhou Province, People's Republic of China.
The Third Department of Orthopedics, Baoding First Central Hospital, Baoding, Hebei, People's Republic of China.
Sci Rep. 2025 May 14;15(1):16699. doi: 10.1038/s41598-025-00881-y.
The primary purpose was to assess the incidence and predictors for mortality in Chinese geriatric patients with perioperative transfusion following intertrochanteric fracture (IF) surgery. A total of 1260 patients who received perioperative transfusion following IF surgery between Jan. 2016 and Dec. 2018 were included. Data was performed to compare the mortality group and the survival group based on subgroup of follow-up time in univariate, and adjusted Cox regression analysis. Perioperative transfusion factors included total, pre-, intra-, and post-operation transfusion volume, and number of transfusions. In our study, the mortality rate was 0.87%, 1.6%, 2.9%, 7.0%, and 13.4% at 30-day, 3-month, 6-month, 1-year, and 2-year follow-up, respectively. Within 6-month follow-up, the adjusted Cox regression analysis revealed that a high American Society of Anesthesiologists (ASA) score, as well as an increase in volume and number of transfusions leading to rapidly increasing morbidity, were identified as risks with mortality. While advanced age and complications played important roles in mortality from 6-month follow-up. In the present study, a high ASA score, as well as the volume and number of transfusions, were identified as risk factors for mortality after IF surgery in Chinese geriatric patients within 6-month follow-up. However, age and severe complications contributed to mortality in 1- and 2-year follow-up.
主要目的是评估中国老年患者股骨转子间骨折(IF)手术后围手术期输血的死亡率及其预测因素。纳入了2016年1月至2018年12月期间接受IF手术后围手术期输血的1260例患者。进行数据统计,基于随访时间亚组,采用单因素分析以及校正Cox回归分析,对死亡组和存活组进行比较。围手术期输血因素包括总输血量、术前、术中和术后输血量以及输血次数。在我们的研究中,30天、3个月、6个月、1年和2年随访时的死亡率分别为0.87%、1.6%、2.9%、7.0%和13.4%。在6个月的随访期内,校正Cox回归分析显示,美国麻醉医师协会(ASA)评分高,以及输血量和输血次数增加导致发病率迅速上升,被确定为死亡风险因素。而高龄和并发症在6个月后的随访中对死亡率起重要作用。在本研究中,ASA评分高以及输血量和输血次数,被确定为中国老年患者IF手术后6个月内死亡的风险因素。然而,年龄和严重并发症在1年和2年随访中导致死亡。