改良前后P-POSSUM评分系统预测老年人低能量髋部骨折围手术期死亡率的对比研究  

Comparison of perioperative mortality rate before and after the modified P-POSSUM scoring system to predict the elderly around the low-energy hip fractures

作　　者：朱琦 马勇[2] 徐坤云 张杰 

机构地区：[1]江西省萍乡矿业集团总医院骨科,萍乡337000 [2]南昌大学附属第一医院骨科,南昌330006

出　　处：《江西医药》2015年第9期863-868,共6页Jiangxi Medical Journal

摘　　要：目的对比分析P-POSSUM评分系统对预测老年人低能量髋部骨折围手术期死亡率的大小,通过分析预测值和实际值的关系,探讨改良前后该系统预测患者术后死亡率的应用价值。方法选择2012年1月-2014年6月来我院治疗的髋部骨折患者161例,其中股骨颈骨折患者82例,股骨粗隆间骨折患者79例,应用改良前后的P-POSSUM评分系统进行评分,计算患者的预期死亡率,将实际死亡人数(O)与预期死亡人数(E)相比,以O:E的数值比较预期死亡和实际死亡的接近程度,采用卡方检验比较预期值与实际值是否存在统计学差异。结果股骨颈骨折患者82例,男35例,女47例,平均年龄(75.8±5.2)岁,预测值与实际值相比差异仍无统计学意义,改良前预测死亡率的准确性较高与改良后。股骨粗隆间骨折患者79例,男37例,女42例,平均年龄(78.0±8.6)岁,预测值与实际值相比差异无统计学意义但在预测准确率方面改良后较好于改良前。结论 P-POSSUM评分系统对老年人低能量髋部骨折围手术期死亡率有较好的预测能力,股骨颈骨折组改良前与改良后相比,改良前预测死亡率的准确性较高与改良后;股骨粗隆间骨折组,预测准确率方面改良后较好于改良前。Objective To compare P-POSSUM scoring system for predicting the elderly low-energy hip fractures around the size of the perioperative mortality,by analyzing the relationship between predicted and actual values,and to explore improvement of the system before and after the predicted value of postoperative mortality rate. Methods Select January 2012 to June 2014. Hip fracture patients in 161 cases,including 82 cases of patients with intertrochanteric fracture of the femoral neck fractures were 79 cases,P-POSSUM scoring system before and after the application of improved scores,calculate the expected mortality rate of patients,the actual number of deaths（O） and expected number of deaths（E） compared to O：Comparison of the expected value of E near death and actual death degree,using the chi-square test to compare the expected value and the actual value if there is statistically significant. Results 82 cases of femoral neck fracture patients,35 males,47 females,mean age（75.8±5.2） years of age,compared to the predicted value and the actual value is still no statistically significant difference between the higher mortality and improve the accuracy of prediction before improvement after. Intertrochanteric fractures were 79 cases,37 cases of males,42 females,mean age（78.0 ± 8.6） years of age,compared to the predicted value and the actual value,but the difference was not statistically significant improvement in prediction accuracy is better in terms of improvement after ago. Conclusion P-POSSUM scoring system for low-energy hip fractures in the elderly perioperative mortality has good predictive ability,Femoral neck fracture group improved compared with the post-improvement,before improving predict mortality after high accuracy and improved;better than before improved improved fracture group,the prediction accuracy rate of intertrochanteric.

关 键 词：P-POSSUM 髋部骨折 死亡率 预测 

分 类 号：R687.3[医药卫生—骨科学]