老年髋部骨折患者延迟手术的危险因素  

Risk Factors for Delayed Surgery in Elderly Patients with Hip Fractures

作　　者：杨小超 YANG Xiaochao(The Second Department of Orthopedics,Central Hospital of Jiaozuo Coal Industry(Group)Co.LTD,Jiaozuo 454000,China)

机构地区：[1]焦作煤业(集团)有限责任公司中央医院骨科二区,河南焦作454000

出　　处：《河南医学研究》2023年第18期3305-3308,共4页Henan Medical Research

摘　　要：目的 基于多因素logistic回归模型分析影响老年髋部骨折延迟手术的危险因素。方法 回顾性分析2019年9月至2022年9月焦作煤业(集团)有限责任公司中央医院收治的150例老年髋部骨折患者的临床资料,按照入院至接受手术治疗时间分为早期手术组(入院<48 h接受髋部手术,30例)、延迟手术组(入院≥48 h接受手术治疗,120例)。收集两组一般资料与实验室指标[性别、年龄、受教育程度、骨折类型、美国麻醉医师协会(ASA)分级、基础疾病、手术方式、血尿常规、髋关节功能(Harris)评分等],采用多因素logistic回归模型分析影响老年髋部骨折延迟手术的危险因素。结果 早期手术组性别、年龄、受教育程度、骨折类型、手术方式、基础疾病与延迟手术组比较,差异无统计学意义(P>0.05);早期手术组ASA分级Ⅲ~Ⅳ级、心肝肾功能异常、电解质紊乱、合并用药、精神功能障碍占比低于延迟手术组(P<0.05);经二分类logistic回归分析显示,ASA分级Ⅲ~Ⅳ级、心功能异常、电解质紊乱、合并用药、精神功能障碍是老年髋部骨折延迟手术发生的危险因素(OR>1,P<0.05)。结论 老年髋部骨折延迟手术的发生与ASA分级Ⅲ~Ⅳ级、心功能异常、电解质紊乱、合并用药、精神功能障碍等因素相关,临床应针对风险因素制定相应措施,以提高手术疗效,改善预后。Objective To analyze the risk factors of delayed hip fracture surgery in the elderly based on multivariate logistic regression model.Methods The clinical data of 150 elderly patients with hip fracture in the Central Hospital of Jiaozuo Coal Industry(Group)Co.LTD from September 2019 to September 2022 were retrospectively analyzed.According to the time from admission to operative treatment,they were divided into early operation group(30 cases who received hip surgery when they were admitted<48 h)and delayed operation group(120 cases who received surgery when they were admitted≥48 h).The general data and laboratory indicators[gender,age,educational level,fracture type,American Society of Anesthesiologists(ASA)classification,basic disease,operation method,hematuria routine,and hip joint function(Harris)score]of the two groups were collected,and the risk factors affecting the delayed operation of hip fracture in the elderly were analyzed by multi-factor logistic regression model.Results Compared with the delayed operation group,the early operation group had no significant differences in gender,age,educational level,fracture type,operation method,basic disease(P>0.05).The proportion of patients with ASA gradeⅢ-Ⅳ,cardiac,liver and renal dysfunction,electrolyte disorders,concomitant medication and mental dysfunction in the early operation group were lower than those in the delayed operation group(P<0.05).According to the binary logistic regression analysis,ASA gradeⅢ-Ⅳ,cardiac dysfunction,electrolyte disturbance,concomitant medication and mental dysfunction were the risk factors for delayed surgery of hip fracture in the elderly(OR>1,P<0.05).Conclusion The delayed operation of hip fracture in the elderly is associated with ASA gradeⅢ-Ⅳ,cardiac dysfunction,electrolyte disorders,concomitant medication,and mental dysfunction.Therefore,corresponding measures should be taken in accordance with the risk factors in order to improve the curative effect of the operation and the prognosis.

关 键 词：髋部骨折 老年人 延迟手术 

分 类 号：R684.1[医药卫生—骨科学]