中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2012年
2期
93-97
,共5页
髋骨折%死亡率%脑血管意外%治疗结果%预测
髖骨摺%死亡率%腦血管意外%治療結果%預測
관골절%사망솔%뇌혈관의외%치료결과%예측
Hip fractures%Mortality%Cerebrovascular accident%Treatment outcome%Fore
目的 探讨卒中后偏瘫的老年髋部骨折患者的一般特征及术后1年内死亡的相关影响因素.方法 回顾性分析2000年1月至2007年5月手术治疗的老年髓部骨折患者资料.比较偏瘫组与非偏瘫组患者的一般特点,分析偏瘫组患者1年内死亡的相关影响因素.分析的变量包括:年龄、性别、美国麻醉医师协会(ASA)分级、术前合并疾病数量及种类、骨折类型、骨折前活动能力、认知能力、住院时间、受伤至手术时间、麻醉方式及手术方式等.结果 共有1379例患者符合纳入标准,平均年龄为(76.4±7 0)岁(65 ～99岁)；其中101例患者髋部骨折前患有卒中后偏瘫.偏瘫组与非偏瘫组患者的ASA分级、术前合并疾病数量、骨折前活动能力、认知能力、住院时间及术后1年存活情况差异均有统计学意义(P＜0.05).偏瘫组患者术后1年髓访,25例患者死亡,病死率为24.8％.多因素Logistic回归分析结果显示:性别(P=0.017)、ASA分级(P=0.009)、术前合并疾病数量(P=0.048)、骨折前活动能力(P=0.000)及慢性呼吸系统疾病(P=0.022)是偏瘫患者术后1年死亡的危险因素. 结论 偏瘫组患者较非偏瘫组患者住院时间长,死亡率高.男性患者、ASA分级为Ⅲ或Ⅳ级、术前合并疾病≥3种、慢性呼吸系统疾病及弱的骨折前活动能力是影响卒中后偏瘫的老年髋部骨折患者术后1年内死亡的危险因素.
目的 探討卒中後偏癱的老年髖部骨摺患者的一般特徵及術後1年內死亡的相關影響因素.方法 迴顧性分析2000年1月至2007年5月手術治療的老年髓部骨摺患者資料.比較偏癱組與非偏癱組患者的一般特點,分析偏癱組患者1年內死亡的相關影響因素.分析的變量包括:年齡、性彆、美國痳醉醫師協會(ASA)分級、術前閤併疾病數量及種類、骨摺類型、骨摺前活動能力、認知能力、住院時間、受傷至手術時間、痳醉方式及手術方式等.結果 共有1379例患者符閤納入標準,平均年齡為(76.4±7 0)歲(65 ～99歲)；其中101例患者髖部骨摺前患有卒中後偏癱.偏癱組與非偏癱組患者的ASA分級、術前閤併疾病數量、骨摺前活動能力、認知能力、住院時間及術後1年存活情況差異均有統計學意義(P＜0.05).偏癱組患者術後1年髓訪,25例患者死亡,病死率為24.8％.多因素Logistic迴歸分析結果顯示:性彆(P=0.017)、ASA分級(P=0.009)、術前閤併疾病數量(P=0.048)、骨摺前活動能力(P=0.000)及慢性呼吸繫統疾病(P=0.022)是偏癱患者術後1年死亡的危險因素. 結論 偏癱組患者較非偏癱組患者住院時間長,死亡率高.男性患者、ASA分級為Ⅲ或Ⅳ級、術前閤併疾病≥3種、慢性呼吸繫統疾病及弱的骨摺前活動能力是影響卒中後偏癱的老年髖部骨摺患者術後1年內死亡的危險因素.
목적 탐토졸중후편탄적노년관부골절환자적일반특정급술후1년내사망적상관영향인소.방법 회고성분석2000년1월지2007년5월수술치료적노년수부골절환자자료.비교편탄조여비편탄조환자적일반특점,분석편탄조환자1년내사망적상관영향인소.분석적변량포괄:년령、성별、미국마취의사협회(ASA)분급、술전합병질병수량급충류、골절류형、골절전활동능력、인지능력、주원시간、수상지수술시간、마취방식급수술방식등.결과 공유1379례환자부합납입표준,평균년령위(76.4±7 0)세(65 ～99세)；기중101례환자관부골절전환유졸중후편탄.편탄조여비편탄조환자적ASA분급、술전합병질병수량、골절전활동능력、인지능력、주원시간급술후1년존활정황차이균유통계학의의(P＜0.05).편탄조환자술후1년수방,25례환자사망,병사솔위24.8％.다인소Logistic회귀분석결과현시:성별(P=0.017)、ASA분급(P=0.009)、술전합병질병수량(P=0.048)、골절전활동능력(P=0.000)급만성호흡계통질병(P=0.022)시편탄환자술후1년사망적위험인소. 결론 편탄조환자교비편탄조환자주원시간장,사망솔고.남성환자、ASA분급위Ⅲ혹Ⅳ급、술전합병질병≥3충、만성호흡계통질병급약적골절전활동능력시영향졸중후편탄적노년관부골절환자술후1년내사망적위험인소.
Objective To investigate predictors of one year mortality in the elderly patients with hip fracture following poststroke hemiplegia. Methods A retrospective study was conducted to analyze clinical data of the elderly patients who had received surgery in our hospital from January 2000 to May 2007 for hip fractures.Patients in the poststroke hemiplegia group (group A) and the hemiplegia-free group (group B)were compared in terms of general characteristics.Predictors of one year mortality in group A were analyzed statistically.Variables to be analyzed included age,gender,American Society of Anesthesiologists (ASA) rating,preoperative comorbidity,fracture type,prefracture ambulatory status and cognitive ability,hospital stay,interval from injury to surgery,anaesthetic mode and operational mode. Results Altogether 1379 patients with a mean age of 76.4 ± 7.0 years (from 65 to 99 years) were eligible for the present investigation.Of them,101 were assigned into group A.There were significant differences between the 2 groups in ASA rating,number of preoperative comorbidity,prefracture ambulatory status and cognitive ability,hospital stay and one year survival ( P ＜ 0.05).One year follow-up found 25 deaths in group A (mortality rate 24.8％ ).Multiple logistic regression analysis showed that gender ( P =0.017),ASA rating ( P=0.009),prefracture ambulatory status ( P =0.000),chroic respiraory disease ( P =0.022) and number of preoperative comorbidity ( P =0.048) were risk factors associated with the one year mortality in group A. Conclusions Eldarly hip fracture patients with hemiplegia tend to have a longer hospital stay and a higher mortality rate than those without hemiplegia.Male gender,ASA rating ≥ Grade Ⅲ,number of preoperative comorbidity ≥ 3,chronic respiratory disease and weak prefracture ambulatory status are predictors of one year mortality in the elderly patients with hip fracture following poststroke hemiplegia.
