老年髋部骨折术后脑卒中的发生率及其独立危险因素分析
Analysis of the incidence and risk factors of stroke after hip fracture surgery in elderly patients
赵丹枫 1管伟 2刘付玉 2王海彬 2李钰 2李希明2
作者信息
- 1. 锦州医科大学临沂市人民医院研究生培养基地,临沂 276005
- 2. 临沂市人民医院麻醉科,临沂 276005
- 折叠
摘要
目的 探讨老年髋部骨折术后脑卒中的发生率及其独立危险因素.方法 回顾性收集临沂市人民医院2019年6月-2022年6月收治的1 296例择期行髋部骨折手术患者的临床资料,依据术后30 d内是否发生脑卒中分为脑卒中组(30例)和非脑卒中组(1 266例).单因素分析两组患者的基线资料、术前实验室资料、麻醉相关资料、骨折及手术相关资料,将单因素分析中P＜0.2的因素纳入多因素logistic回归分析,探讨老年髋部骨折术后脑卒中的发生率及其独立危险因素.结果本研究共纳入1 296例患者,其中30例术后发生脑卒中,发生率为2.3％.多因素logistic回归分析结果显示,老年髋部骨折术后脑卒中的独立危险因素为美国麻醉医师协会(ASA)分级Ⅲ-Ⅳ级[比值比(OR)4.441,95％置信区间(CI)1.243～15.861,P=0.022]、术前红细胞分布宽度(RDW)(OR 1.057,95％CI 1.006～1.110,P=0.027)较高、颈动脉斑块(OR 2.760,95％CI 1.191～6.395,P=0.018)、术中低血压(OR2.641,95％CI 1.217～5.730,P=0.014).结论 老年髋部骨折术后脑卒中的发生率为2.3％;ASA分级Ⅲ-Ⅳ级、颈动脉斑块、术前RDW较高、术中低血压是老年髋部骨折术后脑卒中的独立危险因素.
Abstract
Objective To investigate the incidence of postoperative stroke and its independent risk factors in elderly patients with hip fractures.Methods A total of 1 296 patients who were admitted to Linyi People's Hospital for elective hip fracture surgery from June 2019 to June 2022 were selected and their clinical data were retrospectively analyzed.According to the presence of stroke within 30 d after surgery,the patients were divided into two groups:a stroke group(n=30)and a non-stroke group(n=1 266).Both groups were compared for baseline data,preoperative laboratory data,anesthesia-related data,and fracture and surgery-related data through univariate analysis.Then,factors with P＜0.2 in the univariate analysis were included in multivariate logistic regression analy-sis to investigate the incidence of postoperative stroke and its independent risk factors in elderly patients with hip fractures.Results A total of 1 296 patients were enrolled in this study,of whom 30 had postoperative stroke,with an incidence rate of 2.3％.The results of multifactorial logistic regression analysis showed that the independent risk factors for postoperative stroke in elderly patients with hip fracture were American Society of Anesthesiologists(ASA)classification Ⅲ and Ⅳ[odds ratio(OR)4.441(95％confidence interval(CI)1.243,15.861),P=0.022],higher preoperative red blood cell distribution width(RDW)[OR 1.057(95％CI 1.006,1.110),P=0.027],carotid plaque[OR 2.760(95％CI 1.191,6.395),P=0.018],and intraoperative hypotension[OR 2.641(95％CI 1.217,5.730),P=0.014].Conclusions The incidence of postoperative stroke in elderly patients with hip fracture is 2.3％.ASA classification Ⅲ andⅣ,carotid plaque,higher preoperative RDW,and intraoperative hypotension are the independent risk factors for postoperative stroke in elderly patients with hip fracture
关键词
老年人/髋部骨折/脑卒中/危险因素/logistic回归分析Key words
Elderly people/Hip fracture/Stroke/Risk factor/logistic regression analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据