摘要
目的探讨髋部骨折保守治疗老年患者的短期死亡原因和死亡相关危险因素。方法选取2013年6月至2019年5月首都医科大学电力教学医院收治的年龄≥65岁的91例因髋部骨折行保守治疗的患者,统计患者1年随访期内病死率,按生存情况分为生存组和死亡组,分析组间死亡相关因素,包括年龄、性别、骨折部位、住院时间、患者伤前活动能力、内科合并症以及血液学指标。结果随访1年,91例患者中21例死亡,病死率23.1%,死于呼吸系统疾病16例、心血管疾病4例、脑梗死1例。单因素分析结果显示,与死亡相关的危险因素包括年龄、伤前活动能力、住院时间、合并呼吸系统疾病、至少两种内科合并症(P<0.05)。多因素分析显示,患者伤前能力是老年髋部骨折保守治疗短期死亡的独立危险因素(P<0.05)。结论老年髋部骨折患者行保守治疗短期病死率高,主要死因是呼吸系统疾病。多种因素与死亡相关,患者伤前活动能力差是短期死亡的独立危险因素。患者住院后应积极防治呼吸系统疾病,必要时无需严格卧床以减少卧床并发症的发生,从而延长患者生存时间,降低病死率。
Objective To observe the death cause of the eldly patients with hip fracture after one year of conservative treatment and evaluate the associated risk factors.Methods Ninty-one patients over 65 years old who had a hip fracture were followed up.The mortality rate of one-year follow-up was calculated.According to the survival situation,the patients were divided into the survival group and the death group.The correlation factors between the two groups were analyzed,including age,gender,fracture area,hospital stay,pre-injury activity,internal medicine,and haematological data.Results Twenty-one patients died during the follow-up and the mortality rate was 23.1%.Sixteen patients died of respiratory disease,four died of cardiovascular disease,and one died of cerebral infarction.The mortality was associated with age,hospital stay,pre-injury activity,respiratory disease and more than two complications(P<0.05).Logistic regression analysis revealed that the independent risk factor affecting the mortality was pre-injury activity(P<0.05).Conclusions The short-term mortality is high for the eldly patients with hip fracture after conservative treatment.The main death cause is respiratory disease.The pre-injury activity was the independent risk factor affecting the short-term mortality.After hospitalization,active prevention of respiratory disease is very important for the elderly patients with hip fracture.When necessary,the patients need not stay in bed strictly in order to reduce the occurrence of bed complications,to prolong the survival.
作者
韩云毅
孙永青
康建国
赵大中
蒋育欣
任磊
邓超
Han Yunyi;Sun Yongqing;Kang Jianguo;Zhao Dazhong;Jiang Yuxin;Ren Lei;Deng Chao(Department of Orthopaedics,Beijing Electric Power Hospital,Beijing 100073,China)
出处
《北京医学》
CAS
2020年第1期21-24,共4页
Beijing Medical Journal
关键词
髋部骨折
保守治疗
死亡
老年
危险因素
hip fracture
conservative treatment
mortality
eldly
risk factor
