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老年髋部骨折患者术后衰弱对发病率和死亡率的影响:前瞻性队列研究

The Effect of Postoperative Frailty on Morbidity and Mortality in Geriatric Hip Fracture Patients: Prospective Cohort Study.

作者信息

Senol Yalçın, Cagiran Zeynep, Karaman Semra, Sertoz Nezih

机构信息

Department of Anesthesiology and Reanimation, Ege University, Izmir, Turkey.

Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, USA.

出版信息

J Perianesth Nurs. 2025 Jun 23. doi: 10.1016/j.jopan.2025.02.007.

Abstract

PURPOSE

Hip fractures are a common health issue in geriatric patients, and their incidence increases with age. The aim of this study was to investigate the changes in frailty status of geriatric patients who underwent hip fracture surgery in the postoperative period, as well as to examine the effects of frailty on morbidity and mortality.

DESIGN

This study was designed as a prospective observational study.

METHODS

The study was conducted between January 2023 and May 2023 in the operating room of the Department of Orthopedics and Traumatology at Ege University Faculty of Medicine. A total of 101 patients who underwent surgery for hip fractures were included in the study. Data were collected using the Edmonton Frail Scale (EFS), Clinical Frailty Scale (CFS), Charlson Comorbidity Index (CCI), Mini-Mental State Examination (MMSE), and Barthel Index (BI). The data collection was conducted through face-to-face interviews.

FINDINGS

During the study period, a total of 101 patients, 68.3% female and 31.7% male, were evaluated. The average Charlson Comorbidity Index score was found to be 5 ± 2. According to the Mini-Mental State Examination, 28.7% had moderate impairment and 25.7% had severe impairment. The mean Barthel Index score on day 0 was determined as 85% ± 15%, and 18.8% of the patients were independent. When their status was re-evaluated at the third month, 14.9% were found to be independent and the average score was 78 ± 22. On postoperative day 0, the average Edmonton Frail Scale score was calculated as 7.3 ± 3, with 16.8% of the patients being severely frail. When evaluated at postoperative month 3, the average score was 7.7 ± 3.7, with 25.7% being severely frail. On postoperative day 0, the Clinical Frailty Scale indicated that 45.5% of the patients were frail, while at postoperative month 3, 37.6% were found to be frail. When contacted at the third postoperative month, 14.9% of the patients had passed away. Analyzing the relationship between mortality and the baseline values of the frailty scales and the baseline Mini-Mental State Examination score, those who had passed away were more frail and had lower scores on the Mini-Mental State Examination.

CONCLUSION

Given the increasing elderly population both globally and in our country, we believe that specialized approaches for the geriatric population will become increasingly important and that frailty should not be overlooked.

摘要

目的

髋部骨折是老年患者常见的健康问题,其发病率随年龄增长而增加。本研究的目的是调查接受髋部骨折手术的老年患者术后虚弱状态的变化,并探讨虚弱对发病率和死亡率的影响。

设计

本研究设计为前瞻性观察性研究。

方法

该研究于2023年1月至2023年5月在伊兹密尔大学医学院骨科与创伤科手术室进行。共有101例接受髋部骨折手术的患者纳入本研究。使用埃德蒙顿虚弱量表(EFS)、临床虚弱量表(CFS)、查尔森合并症指数(CCI)、简易精神状态检查表(MMSE)和巴氏指数(BI)收集数据。数据收集通过面对面访谈进行。

结果

在研究期间,共评估了101例患者,其中女性占68.3%,男性占31.7%。查尔森合并症指数平均得分为5±2。根据简易精神状态检查表,28.7%的患者有中度损害,25.7%的患者有重度损害。术后第0天巴氏指数平均得分为85%±15%,18.8%的患者能够自理。在术后第三个月重新评估其状态时,发现14.9%的患者能够自理,平均得分为78±22。术后第0天,埃德蒙顿虚弱量表平均得分为7.3±3,16.8%的患者极度虚弱。在术后第3个月进行评估时,平均得分为7.7±3.7,25.7%的患者极度虚弱。术后第0天,临床虚弱量表显示45.5%的患者虚弱,而在术后第3个月,发现37.6%的患者虚弱。在术后第三个月进行随访时,14.9%的患者已去世。分析死亡率与虚弱量表基线值和基线简易精神状态检查表得分之间的关系,去世的患者更虚弱,且在简易精神状态检查表上得分更低。

结论

鉴于全球和我国老年人口不断增加,我们认为针对老年人群的专门方法将变得越来越重要,且不应忽视虚弱问题。

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