Charlson合并症指数对老年股骨粗隆间骨折术后并发症的预测效果  

Predictive efficiency of Charlson comorbidity index for postoperative complications in the elderly with intertrochanteric fractures

作　　者：张明清 孙莉莉[1] 毕然 王聪[1] Zhang Mingqing;Sun Lili;Bi Ran;Wang Cong(Department of Emergency Medicine,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院急诊科,北京100035

出　　处：《中华老年多器官疾病杂志》2023年第3期176-180,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：首都卫生发展科研专项(首发2022-2-2073)。

摘　　要：目的分析Charlson合并症指数(CCI)对老年股骨粗隆间骨折术后并发症的预测价值。方法对2017年1月至2018年1月于北京积水潭医院收治的378例股骨粗隆间骨折接受髋关节手术治疗的老年患者进行回顾性队列研究。以CCI=4分为界限分组,分为高风险组(CCI≥4分)及低风险组(CCI<4分),主要研究终点是术后30 d内并发症。采用SPSS 22.0统计软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。采用Cox回归分析确定CCI与术后并发症的相关性。结果378例患者中,高风险组患者67例,低风险组患者311例。高风险组术后并发症发生率[64.2%(43/67)和49.8%(155/311)]、术后重症监护室(ICU)使用率[29.9%(20/67)和16.7%(52/311)]、全身麻醉率[50.7%(34/67)和37.6%(117/311)]显著高于低风险组,差异均有统计学意义(均P<0.05)。在多变量模型中,CCI与术后并发症显著相关(RR=1.13,95%CI 1.011~1.253,P=0.026),其他危险因素包括全身麻醉方式手术(RR=1.59,95%CI 1.373~1.943,P=0.026)和术后ICU住院情况(RR=1.34,95%CI 1.180~1.642,P=0.001)。结论CCI可用于评估预测老年股骨粗隆间骨折患者术后并发症。Objective To analyze the predictive value of the Charlson comorbidity index(CCI)for postoperative complications of femoral intertrochanteric fractures in the elderly.Methods A retrospective cohort study was conducted on 378 elderly patients who underwent hip surgery for femoral intertrochanteric fractures between January 2017 and January 2018 in our hospital.Taking CCI=4 points as standard,they were divided into high-risk group(CCI≥4 points)and a low-risk group(CCI<4 points).The primary study endpoint was occurrence of complications within 30 d postoperatively.SPSS statistics 22.0 was used for statistical analysis.Student′s t test or Chi-square test was performed for comparison between two groups depending on data type.Cox regression analysis was adopted to determine the relationship between CCI and postoperative complications.Results Of the 378 patients,there were 67 patients in the high-risk group and 311 in the low-risk group.The high-risk group had significantly higher incidence of postoperative complications[64.2%(43/67)vs 49.8%(155/311)],ratio of postoperative admission to ICU[29.9%(20/67)vs 16.7%(52/311)],and proportion of general anaesthesia[50.7%(34/67)vs 37.6%(117/311)]than the low-risk group(all P<0.05).In the multivariate model,CCI was significantly associated with postoperative complications(RR=1.13,95%CI 1.011-1.253,P=0.026).Other risk factors included general anesthesia(RR=1.59,95%CI 1.373-1.943,P=0.026)and postoperative ICU stay(RR=1.34,95%CI 1.180-1.642,P=0.001).Conclusion CCI can be used to assess and predict postoperative complications in elderly patients with intertrochanteric femoral fractures.

关 键 词：Charlson合并症指数 股骨粗隆间骨折 术后并发症 

分 类 号：R274[医药卫生—中医骨伤科学]