老年股骨转子间骨折患者闭合复位髓内钉内固定术后1年死亡风险预测列线图模型构建  

Construction of Nomograms Model for Predicting the 1-year Mortality Risk after Close Reduction and Intramedullary Fixation in Elderly Patients with Femoral Intertrochanteric Fracture

作　　者：何志燕 HE Zhiyan(Department of Trauma Orthopedics,the First Hospital of Putian City,Putian 351100,China)

机构地区：[1]莆田市第一医院创伤骨科,福建莆田351100

出　　处：《中国医学创新》2025年第6期153-157,共5页Medical Innovation of China

摘　　要：目的:系统分析老年股骨转子间骨折患者接受闭合复位髓内钉内固定术后1年死亡的危险因素并构建预测模型,为提升该类患者的护理干预效果提供科学、有效的参考依据。方法:回顾性分析2019年5月—2023年5月莆田市第一医院收治的进行闭合复位髓内钉内固定术治疗的老年股骨转子间骨折患者223例,根据患者术后1年是否死亡分为死亡组(n=24)和存活组(n=199)。比较两组患者的临床资料,分析老年股骨转子间骨折患者闭合复位髓内钉内固定术后1年死亡的影响因素,并构建列线图模型,并以决策曲线分析(DCA)评估列线图模型的应用价值。结果:老年股骨转子间骨折患者闭合复位髓内钉内固定术后1年的死亡率为10.76%。单因素分析显示,两组年龄、骨折类型、骨质疏松、合并内科疾病、白蛋白、肺部感染、糖尿病比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄>72岁、不稳定型骨折、骨质疏松、合并内科疾病>2种、白蛋白≤35 g/L、肺部感染、糖尿病是老年股骨转子间骨折患者闭合复位髓内钉内固定术后1年死亡的独立危险因素(P<0.05)。结论:年龄>72岁、不稳定型骨折、骨质疏松、合并内科疾病>2种、白蛋白≤35 g/L、肺部感染、糖尿病是老年股骨转子间骨折患者闭合复位髓内钉内固定术后1年死亡的独立危险因素。Objective:To systematically analyze the risk factors and construct a predictive model of 1-year mortality of elderly patients with femoral intertrochanteric fracture after receiving close reduction and intramedullary fixation one year,to provide scientific and effective reference for improving the nursing intervention effect of such patients.Method:A total of 223 elderly patients with femoral intertrochanteric fracture treated by close reduction and intramedullary fixation in the First Hospital of Putian City from May 2019 to May 2023 were retrospectively analyzed.They were divided into death group(n=24)and survival group(n=199)based on whether the patients died 1 year after surgery.The clinical data of the two groups of patients were compared,and the influencing factors of 1-year mortality after close reduction and intramedullary fixation in elderly patients with femoral intertrochanteric fracture were analyzed,and the nomogram model was constructed,and the application value of the nomogram model was evaluated by decision curve analysis(DCA).Result:The 1-year mortality rate of elderly patients with with femoral intertrochanteric fracture after receiving close reduction and intramedullary fixation was 10.76%.Univariate analysis showed that there were statistically significant differences in age,fracture type,osteoporosis,combined medical disease,albumin,pulmonary infection and diabetes between the two groups(P<0.05).Multivariate logistic regression analysis showed that age>72 years old,unstable fracture,osteoporosis,combined medical diseases>2 kinds,albumin≤35 g/L,pulmonary infection and diabetes were independent risk factors for 1-year mortality after close reduction and intramedullary fixation in elderly patients with femoral intertrochanteric fracture(P<0.05).Conclusion:Age>72 years old,unstable fracture,osteoporosis,combined medical diseases>2 kinds,albumin≤35 g/L,pulmonary infection and diabetes are independent risk factors for 1-year mortality after close reduction and intramedullary fixation in elderly

关 键 词：股骨转子间骨折 术后死亡 列线图模型 闭合复位髓内钉内固定术 

分 类 号：R687.3[医药卫生—骨科学]