摘要
目的探讨老年髋部骨折术前合并急性脑梗塞的危险因素。方法收集2013年1月至2016年12月上海交通大学附属新华医院收治的老年髋部骨折病例,术前常规行头颅核磁共振检查,记录并分析脑梗塞和无脑梗塞两组患者的年龄、性别、血脂水平、骨折部位、既往病史(包括高血压、糖尿病、房颤)、吸烟史、饮酒史和使用抗凝药物史,采用多因素Logistic回归分析老年髋部骨折术前合并脑梗塞的危险因素。结果共纳入349例患者,其中45例(13%)出现急性脑梗塞。单因素分析显示组间高血压病史(χ~2=15.382,P<0.01)、高血脂(χ~2=5.382,P<0.05)、糖尿病史(χ~2=7.108,P<0.01)、房颤病史(χ~2=12.678,P<0.01)及抗凝药物使用史(χ~2=43.107,P<0.01)的差异有统计学意义。多因素Logistic回归分析显示老年髋部骨折术前合并脑梗塞的危险因素有高血压病史,OR值为1.144(95%CI:0.087~0.182);糖尿病史,OR值为1.724(95%CI:0.176~0.914);高血脂,OR值为2.843(95%CI:0.226~0.863);房颤病史,OR值为2.126(95%CI:1.281~3.528)。结论高血压病史、糖尿病史、高血脂和房颤病史是老年髋部骨折术前合并脑梗塞的独立危险因素,该类患者应常规行头颅核磁共振检查以明确有无合并急性脑梗塞。
Objective To investigate relative risk factors of preoperative acute cerebral infarction in elderly patients with hip fracture.Methods Patients with hip fractures diagnosed between January2013and December2016in Hospital Affiliated to Shanghai Jiaotong University School of Medicine were enrolled in this study.All patients had magnetic resonance imaging examination before operation.Age,gender,serum lipid level,BMI,medical history(hypertension,diabetes,atrial fibrillation),smoking,drunk and anticoagulant drug use history of acute cerebral infarction group and non-acute cerebral infarction group were recorded preoperatively and analysis were done using Multi-factor Logistic regression analysis.Results171cases were included,15patients(9%)had acute cerebral infarction.There were significant differences on hypertension(c2=15.382,P=0.020),hyperlidemia(c2=5.382,P=0.002),diabetes(c2=7.108,P<0.01),atrial fibrillation(c2=12.678,P<0.01),anticoagulant drug use history(c2=43.107,P=0.006)by single factor analysis.While multi-factor Logistic regression analysis showed that OR of hypertension was1.144(95%CI:0.087,0.182);OR of diabetes was1.724(95%CI:0.176,0.914);OR of hyperlidemia was2.843(95%CI:0.226,0.863);OR of atrial fibrillation was2.126(95%CI:1.281,3.528).Conclusion Hypertension,hyperlidemia,diabetes and atrial fibrillation are independent risk factors of acute cerebral infarction in elderly patients with hip fractures.Such patients should have routine magnetic resonance imaging examination before operation.
作者
沈浩
王伟
何继业
张翔
陈晓东
Shen Hao;Wang Wei;He Jiye;Zhang Xiang;Chen Xiaodong(Department of Orthopaedic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China)
出处
《中华老年骨科与康复电子杂志》
2017年第5期275-280,共6页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
国家自然科学基金(81572172)
关键词
髋骨折
老年人
脑梗塞
Hip fractures
Aged
Cerebral infarction
