老年股骨颈骨折患者人工股骨头置换术后死亡的危险因素分析  

Risk factors analysis for postoperative mortality of elderly patients with femoral neck fracture undergoing hemiarthroplasty

作　　者：鲁攀攀 谢添 代广春[1,2,3,4,5] 李荥娟 邹继红[2,5,6] 陈辉[1,2,3,4,5] 芮云峰 LU Panpan;XIE Tian;DAI Guangchun;LI Yingjuan;ZOU Jihong;CHEN Hui;RUI Yunfeng(Department of Orthopedic Trauma,Zhongda Hospital Southeast University,Nanjing jiangsu,210009,P.R.China;Muticiplinary Team(MDT)for Geriatric Hip Fracture Management,Zhongda Hospital Southeast University,Nanjing liangsu,210009,P.R.China;Trauma Center,Zhongda Hospital Southeast University,Nanjing Jiangsu,210009,P.R.China;Orthopaedic Trauma Institute of Southeast University,Nanjing Jiangsu,210009,P.R.China;School of Medicine,Southeast University,Nanjing Jiangsu,210009,P.R.China;Department of Geriatrics,Zhongda Hospital Southeast University,Nanjing liangsu,210009,P.R.China)

机构地区：[1]东南大学附属中大医院创伤骨科,南京210009 [2]东南大学附属中大医院老年髋部骨折多学科综合诊疗协作组(MDT),南京210009 [3]东南大学附属中大医院创伤救治中心,南京210009 [4]东南大学创伤骨科研究所,南京210009 [5]东南大学医学院,南京210009 [6]东南大学附属中大医院老年科,南京210009

出　　处：《中国修复重建外科杂志》2021年第2期217-220,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：江苏省科教强卫医学重点人才项目(ZDRCA2016083);南京市科学与技术委员会软科学研究计划项目(2016ZD014);江苏省瑞华慈善基金资助项目。

摘　　要：目的分析老年股骨颈骨折患者人工股骨头置换术后死亡率及其危险因素。方法以2011年1月—2015年12月因股骨颈骨折行人工股骨头置换术患者为研究对象,将符合选择标准的109例患者纳入研究,收集临床资料,包括年龄、性别、合并基础疾病数量、入院至手术时间以及术前血红蛋白、营养状况。采用单因素分析和Cox比例风险回归模型筛查术后死亡危险因素。结果术后1年和2年死亡率分别为6.4%(7/109)和17.4%(19/109)。单因素分析显示年龄、术前血红蛋白水平和营养状况是患者术后死亡的影响因素(P<0.05)。多因素分析显示,年龄≥80岁和营养不良是患者术后死亡的独立危险因素(P<0.05)。结论老年股骨颈骨折患者人工股骨头置换术后死亡率高,对于此类患者,尤其是高龄和营养不良者,应多学科综合评估围术期风险,加强围手术期管理和优化,以改善临床预后。Objective To analyze the risk factors for postoperative mortality of the elderly patients with femoral neck fracture undergoing hemiarthroplasty.Methods Patients who underwent hemiarthroplasty for femoral neck fractures between January 2011 and December 2015 were enrolled as object.One hundred and nine patients who met the selection criteria were included in the study,and the clinical data were collected,including gender,age,time from admission to surgery,comorbidities,and preoperative hemoglobin level and nutritional status.Univariate analysis and Cox proportional hazard regression model were used to screen the risk factors for postoperative mortality.Results The 1-year and 2-year mortalities were 6.4%(7/109)and 17.4%(19/109),respectively.Univariate analysis showed that the age,preoperative hemoglobin level and nutritional status were the influencing factors of postoperative mortality in the elderly patients with femoral neck fractures treated with hemiarthroplasty(P<0.05).Multivariate analysis showed that the age≥80 years and malnutrition were the independent risk factors for postoperative mortality(P<0.05).Conclusion To improve the clinical outcomes,perioperative risk should be comprehensively evaluated by multidisciplinary and perioperative management should be strengthened in the elderly patients with femoral neck fracture,especially those with advanced age and malnutrition,for the high postoperative mortality.

关 键 词：股骨颈骨折 老年人 人工股骨头置换术 死亡率 危险因素 

分 类 号：R687.3[医药卫生—骨科学]