两种评分判别高龄髋部骨折手术风险的价值  

Predicating value of O-POSSUM and Nottingham scores for surgical risks of hip fractures in elderly

作　　者：王红旗[1] 黄久勤[1] WANG Hong-qi;HUANG Jiu-qin(Department of Orthopedics,Shangqiu First People's Hospital,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院骨一科,河南商丘476100

出　　处：《中国矫形外科杂志》2020年第22期2032-2035,共4页Orthopedic Journal of China

摘　　要：[目的]探讨O-POSSUM评分与Nottingham评分预判高龄髋部骨折患者手术风险的价值。[方法]回顾性分析2015年1月~2019年6月228例高龄髋部骨折患者病例资料。进行O-POSSUM评分与Nottingham评分,记录患者术后实际并发症与死亡情况。评价两种评分系统预判的价值。[结果]采用O-POSSUM评分预测并发症86例(37.71%),实际发生并发症67例(29.38%),两者之间差异无统计学意义(P<0.05)。O-POSSUM评分预测术后死亡为7例(3.07%),实际死亡为3例(1.32%),差异有统计学意义(P<0.05)。按是否发生并发症将228例患者分为两组,两组骨折部位、性别差异无统计学意义(P>0.05);但是,并发症组年龄显著大于无并发症组(P<0.05),并发症组内固定比率和全麻比率高于无并发症组(P<0.05),并发症组术中失血量、住院时间、住院费用、O-POSSUM评分和术前Nottingham评分显著高于无并发症组(P<0.05)。[结论]O-POSSUM评分与Nottingham评分均能较为准确的预测高龄髋部骨折患者术后并发症发生率,但术者仍应注意手术方式、麻醉方式、围手术期失血量等因素对手术风险的影响。[Objective]To explore the predicating value of the O-POSSUM and Nottingham score for surgical risks of hip fractures in the elderly.[Methods]A retrospective study was conducted on 228 patients who underwent surgical treatments for hip fractures from January 2015 to June 2019.After the O-POSSUM and Nottingham scorings were conducted,and real compli⁃cations and mortality were recorded,the predicating value of the two scores were evaluated.[Results]The complications oc⁃curred in 86 patients(37.71%)predicated by using O-POSSUM score,whereas 67 patients(29.38%)in reality,which was not statistically significant(P>0.05).However,the death was of 7 patients(3.07%)by predication using the O-POSSUM score,whereas 3 patients(1.32%)in the actual condition,which was of statistical significance(P<0.05).The 228 patients were divid⁃ed into two groups based on whether or not complication happened.Although the complication group proved not statistically dif⁃ferent with the non-complication group in fracture locations and genders,the complication group was significantly older,signifi⁃cantly more ratio of internal fixation and more ratio of general anesthesia,significantly greater intraoperative blood loss,hospital stay,hospital expense,O-POSSUM and Nottingham scores than the non-complication group(P<0.05).[Conclusion]The OPOSSUM and Nottingham scores could be used to predict the surgical risk for hip fracture in the elderly.In addition,the im⁃pacts of intraoperative blood loss,surgical modes and anesthetic modes should also be considered.

关 键 词：髋部骨折 骨科生理学和手术严重程度评分(O-POSSUM) Nottingham 评分 术后并发症 

分 类 号：R683.3[医药卫生—骨科学]