摘要
背景:随着社会的发展及人口老龄化进程的加快,老年人髋部骨折的发生率呈上升趋势,且具有极高的致残率及死亡率。因此,有必要对可能导致老年髋部骨折患者死亡的危险因素进行分析。目的:对国内外老年髋部骨折死亡危险因素进行系统分析。方法:计算机检索Pub Med、Medline、EMBASE、Cochrane图书馆、中国学术期刊全文数据库、维普数据库等资源,筛选老年髋部骨折死亡危险因素的相关文献,利用Stata11.0软件对老年髋部骨折死亡危险因素进行Meta数据分析,并计算各危险因素的合并比值(OR)及95%置信区间(95%CI),从患者自身因素、医源性因素2个方面分析老年髋部骨折的死亡危险因素。结果与结论:1经检索共获得47篇文献,纳入Meta分析27篇;2Meta分析结果显示:男性、年龄大于60岁、体质量指数、美国麻醉师协会评分高、骨折到手术延迟时间、骨折前日常生活能力差、骨折类型、骨折前肺病、骨折前心血管疾病和骨折前痴呆是老年髋部骨折后死亡的主要危险因素;3结果表明,老年髋部骨折患者死亡率高可能是老年人生理状况、手术因素、术后康复等多种因素共同作用的结果,治疗前充分了解患者的身体机能和健康状况,充分评估手术风险,选择适宜的手术类型,从而减小相关治疗后并发症的发病率和死亡率,改善患者的预后。
BACKGROUND：At present,with the aging trend of the world＇s population and social development,the proportion of hip fracture is on the rise,and the morbidity and mortality rate are high.Therefore,it is necessary to analyze the risk factors for death in old patients with hip fractures.OBJECTIVE：To review and systematically analyze the death risk factors for hip fracture all over the world.METHODS：The Pub Med,Medline,EMBASE,the Cochrane library,China Knowledge Resource Integrated Database,VIP database resources were reviewed for mortality risk factors for hip fracture in the elderly.Meta analysis of mortality risk factors for hip fracture in the elderly was conducted by Stata11.0 software,and then the pooled odd ratio（ORs） and 95% confidence interval（95% CI） of each risk factor were calculated from the patient＇s own factors and iatrogenic factors in order to analyze risk factors for hip fracture in the elderly.RESULTS AND CONCLUSION：（1） 47 literatures were searched and among them 27 literatures were included in our meta-analysis.（2） The results of meta-analysis showed that mortality risk factors for hip fracture in the elderly included male,older than 60 years of age,body mass index,high American Society of Anesthesiologists Score,delay time from fracture to surgery,poor daily living before fracture,type of fracture,pre-fracture lung disease,pre-fracture cardiovascular disease,and pre-fracture dementia.（3） Results indicated that high mortality of the elderly patients with hip fractures possibly resulted from combined actions of physiological condition,operative factors and postoperative rehabilitation.Before treatment,fully understanding the patient＇s physical function and health status,fully assessing the risk of surgery,and selecting the appropriate type of surgery can reduce complication rate and mortality and improve patients＇ prognosis.
出处
《中国组织工程研究》
CAS
北大核心
2016年第26期3929-3937,共9页
Chinese Journal of Tissue Engineering Research
