脆性髋部骨折的近期死亡率及相关危险因素研究  

The early mortality and related risk factors of fragile hip fracture

作　　者：王培文[1] 李毅中[1] 林金矿[1] 姚学东[1] 俞海明[1] 庄华烽[1] 林晓聪[1] 

机构地区：[1]福建医科大学附属第二医院骨科,泉州362000

出　　处：《中华骨科杂志》2014年第7期730-735,共6页Chinese Journal of Orthopaedics

摘　　要：目的 观察脆性髋部骨折患者3个月、1年及随访期总的死亡率并分析与死亡率相关的危险因素.方法 回顾性分析2010年1月至2012年12月治疗且获得随访的286例年龄超过50岁的脆性髋部骨折患者资料,男100例,女186例;年龄50～ 97岁,平均（77.09±10.65）岁.统计患者3个月、1年、随访期总的死亡率,并分析与死亡率相关的危险因素,包括年龄、性别、是否手术、受伤到手术时间、住院期间是否出现肺部感染、伤前合并内科疾病数量及种类.结果 286例患者随访时间为6～ 42个月,平均（21.42±9.88）个月,3个月累计死亡率为7.69％（22/286）;随访超过1年的患者有231例,1年累计死亡率为16.02％（37/231）;随访期累计总的死亡率为17.48％（50/286）.单因素分析结果显示,与死亡率相关的危险因素包括年龄、性别、是否手术、受伤到手术时间、伤前合并内科疾病数量、住院期间肺部感染、伤前合并心血管疾病及呼吸系统疾病.多因素Logistic回归分析显示年龄（OR=5.385,P=0.003）、是否手术（OR=21.217,P=0.000）、伤前合并内科疾病数量（OR=9.038,P=0.000）、伤前合并心血管疾病（OR=3.201,P=0.041）是影响脆性髋部骨折患者近期死亡率的独立危险因素.结论 脆性髋部骨折患者近期死亡率高,3个月时为7.69％,1年时为16.02％;多种因素与死亡率相关,其中年龄、是否手术、伤前合并内科疾病数量、伤前合并心血管疾病是影响脆性髋部骨折患者近期死亡率的独立危险因素.伤后积极处理内科合并症,条件允许下尽早手术,可降低患者近期死亡率.Objective To observe the mortality of fragile hip fractures and evaluate the death-associated risk factors.Methods 100 men and 186 women aged 50 to 97 （mean,77.09± 10.65） years old who had fragile hip fracture over 50 years old from 2010 to 2012 were followed up,and the clinical data were retrospectively analyzed.Three months,one year and the total mortality of following time were calculated.Mortality-related risk factors were evaluated including age,gender,and surgery,duration from injury to operation,pulmonary infection,number and kind of complications.Results The 286 patients were followed up between 6 months and 42 months,with 21.42±9.88 months in average.The three month mortality was 7.69％,the patients who were followed up over one year were 231 cases,the one year mortality was 16.02％,and the total mortality of following time was 17.48％.The mortality was associated with age,gender,surgery,duration from injury to operation,number of complications,pre-injury cardiovascular disease and respiratory system diseases,and pulmonary infection.A Binary Logistic Regression analysis revealed that the independent risk factors affecting the mortality included age （OR=5.385,P=0.003）,surgery （OR=21.217,P=0.000）,number of complications （OR=9.038,P=0.000）,pre-injury cardiovascular disease （OR=3.201,P=0.041）.Conclusion The early mortality of fragile hip fractures was high and was associated with many risk factors.Age,surgery,number of complications and pre-injury cardiovascular disease were the independent risk factors affecting the mortality of fragile hip fractures.The positive treatment with complications,early surgery in condition allowed,can lower the early mortality.

关 键 词：髋关节 骨质疏松性骨折 死亡率 危险因素 

分 类 号：R683[医药卫生—骨科学]