老年髋部骨折患者术后一年内死亡危险因素的Meta分析  

Meta-analysis of risk factors of death in elderly patients after hip fracture surgery within one year

作　　者：于健 王爱 李月 常雅茹 周冰倩 郭红玉 曹虹[1] YU Jian WANG Ai;LI Yue;CHANG Ya-ru;ZHOU Bing-qian;GUO Hong-yu;CAO Hong(Department of Orthopaedic Trauma Tianjin Hospital,Tianjin,300202,China)

机构地区：[1]天津医院创伤骨科,天津300202 [2]天津中医药大学研究生院,天津300061

出　　处：《中国骨与关节杂志》2023年第6期441-449,共9页Chinese Journal of Bone and Joint

摘　　要：目的系统评价老年髋部骨折患者术后1年内死亡的危险因素。方法检索PubMed、Embase、Web of science、cochrane library数据库中老年髋部骨折患者死亡危险因素的队列研究和病例对照研究,检索时限为建库至2021年12月15日。由2位研究人员独立筛选文献,提取资料并使用纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。笔者使用通用方差倒数法分析结果,固定和随机效应模型合并效应值,χ^(2)统计量和I^(2)统计量评估异质性。结果共纳入28篇文献,涉及32939例患者,Meta分析显示年龄、性别、ASA分级、CCI评分、骨折类型、术前等待时间、贫血、糖尿病、心力衰竭、心律失常、肺炎、COPD、谵妄、老年痴呆是髋部骨折患者术后1年内死亡的危险因素。结论本Meta分析识别了老年髋部骨折患者术后1年内死亡影响因素,为临床人员对其不良预后的评估和筛查提供理论依据。Objective To systematically evaluate the risk factors of death in elderly patients after hip fracture surgery within one year.Methods The cohort study and case-control study of death risk factors of middle-aged and elderly patients with hip fracture were retrieved from PubMed,Embase,Webofscience,CBM,CNKI and WanFang databases,and the retrieval period was from the establishment of the database to December 15th,2021.Two researchers independently screened the literature,extracted the meta and evaluated the bias risk of inclusion in the study with NOS scale,and then conducted meta-analysis with RevMan5.4 software.The author used the general reciprocal variance method to analyze the results,the fixed and random effect models to collect data,and chi-square statistics and P statistics to evaluate the heterogeneity.Results A total of 28 articles were included in this paper,involving 32939 patients.Meta-analysis showed that age,gender,ASA grade,CCI,fracture type,preoperative waiting time,anemia,diabetes,heart failure,arrhythmia,pneumonia,COPD,delirium and dementia were risk factors for death of hip fracture patients.Conclusions This paper identifies the influencing factors of hip fracture death in the elderly,and provides theoretical basis for clinical staff to evaluate and screen the adverse prognosis.

关 键 词：髋骨折 死亡率 危险因素 META分析 

分 类 号：R683.4[医药卫生—骨科学]