摘要
目的:探讨合并偏瘫的老年髋部骨折患者伤后1年死亡的危险因素.方法:选取2012年1月至2021年12月中国人民解放军总医院第七医学中心收治的223例合并同侧肢体偏瘫的老年髋部骨折患者进行回顾性分析,根据伤后1年是否死亡分为死亡组(73例)和生存组(150例).比较两组患者临床资料,分析合并偏瘫的老年髋部骨折患者伤后1年死亡的危险因素.结果:单因素分析显示,年龄、痴呆、肺部感染、慢性阻塞性肺疾病(COPD)、髋部骨折前日常生活活动能力(ADL)评分、髋部骨折前美国麻醉医师协会(ASA)分级、非手术治疗、住院时间、术后并发症是影响合并偏瘫的老年髋部骨折患者伤后1年死亡的相关因素(P<0.05).多因素logistic回归分析显示,年龄(OR=1.060,95％CI=1.008～1.116,P=0.025)、髋部骨折前ASA Ⅲ～Ⅳ级(OR=3.281,95％CI=1.563～6.884,P=0.002)、髋部骨折前ADL评分(OR=0.890,95％CI=0.847～0.935,P<0.001)、非手术治疗(OR=2.084,95％CI=1.988～4.396,P=0.044)和术后并发症(OR=4.491,95％CI=2.107～9.572,P<0.001)是影响合并偏瘫的老年髋部骨折患者伤后1年死亡的独立危险因素.结论:年龄、髋部骨折前ASA Ⅲ～Ⅳ级、髋部骨折前ADL评分、非手术治疗及术后并发症是影响合并偏瘫的老年髋部骨折患者伤后1年死亡的独立危险因素.因此,对于合并偏瘫的老年髋部骨折患者建议优先选择手术治疗,以改善患者的预后和生活质量.
Abstract
Objective:To compare the risk factors for one-year mortality in elderly hip fracture patients with hemiplegia. Methods:A retrospective analysis was conducted on 223 elderly hip fracture patients with ipsilateral limb hemiplegia who were admitted to the Department of Orthopaedics of the Seventh Medical Center of Chinese People's Liberation Army General Hospital from January 2012 to December 2021. Patients were divided into a mortality group (73 cases) and a survival group (150 cases) based on whether they died within one year post-injury. The clinical data of the two groups were compared to analyze the risk factors for one-year mortality in elderly hip fracture patients with hemiplegia. Results:Univariate analysis showed that age,dementia,pulmonary infection,chronic obstructive pulmonary disease,pre-hip fracture activities of daily living (ADL) score,pre-hip fracture American Society of Anesthesiologists (ASA) classification,nonsurgical treatment,hospital stay,and postoperative complications were significantly related factors to one-year mortality in elderly hip fracture patients with hemiplegia (P<0.05). Multivariate logistic regression analysis revealed that age (OR=1.060,95％CI=1.008-1.116,P=0.025),pre-hip fracture ASA Ⅲ-Ⅳ level (OR=3.281,95％CI=1.563-6.884,P=0.002),pre-hip fracture ADL score (OR=0.890,95％CI=0.847-0.935,P<0.001),nonsurgical treatment (OR=2.084,95％CI=1.988-4.396,P=0.044),and postoperative complications (OR=4.491,95％CI=2.107-9.572,P<0.001) were independent risk factors affecting one-year mortality in elderly hip fracture patients with hemiplegia. Conclusions:Age,dementia,pre-hip fracture ASA grades Ⅲ-Ⅳ,pre-hip fracture ADL score,nonsurgical treatment,and postoperative complications are independent risk factors for one-year mortality in elderly hip fracture patients with hemiplegia. Therefore,surgical treatment should be prioritized for elderly hip fracture patients with hemiplegia to improve their prognosis and quality of life.
维普
万方数据