摘要
目的分析中老年股骨粗隆间骨折内固定术后并发症的危险因素及改良前、后POSSUM评分系统的预测价值。方法回顾性分析2016年3月至2020年3月于西安市中医医院行股骨粗隆间骨折内固定术的92例中老年患者临床资料,将出现术后并发症的纳入观察组,未出现术后并发症的纳入对照组,比较两组的临床资料。采用多因素Logistic回归分析法分析术后并发症危险因素。比较POSSUM评分系统改良前、后预测术后并发症的价值。结果92例中老年股骨粗隆间骨折内固定术患者中,出现术后并发症43例,未出现术后并发症49例。单因素分析结果显示,观察组年龄≥60岁、饮酒、BMI<18.5 kg/m^(2)、术前合并症、术前长期卧床患者占比高于对照组,术后功能锻炼患者占比低于对照组(P<0.05)。多因素Logistic回归分析结果显示,年龄、饮酒、BMI、术前合并症、术前长期卧床是影响中老年股骨粗隆间骨折内固定术后并发症的独立危险因素(P<0.05)。改良后,POSSUM评分系统预测中老年股骨粗隆间骨折内固定术后并发症的特异度、准确度高于改良前(P<0.05)。结论年龄≥60岁、饮酒、BMI<18.5 kg/m^(2)、术前合并症、术前长期卧床是影响中老年股骨粗隆间骨折内固定术后并发症的独立危险因素,改良后POSSUM系统评分对术后并发症的预测价值较高。
Objective To analyze the risk factors of complications after internal fixation of femoral intertrochanteric fracture in the middle-aged and elderly and the predictive value of POSSUM scoring system before and after improvement.Methods The clinical data of 92 middle-aged and elderly patients who underwent internal fixation of femoral intertrochanteric fracture in Xi'an hospital of traditional Chinese medicine from March 2016 to March 2020 were analyzed retrospectively.Those who had postoperative complications were included in observation group and those who no had postoperative complications were included in control group,the clinical data of the two groups were compared.Multivariate Logistic regression analysis method was used to analyze the risk factors of postoperative complications.The value of predicting postoperative complications of POSSUM scoring system before and after improvement was compared.Results Among 92 middle-aged and elderly patients with internal fixation of femoral intertrochanteric fracture,43 cases had postoperative complications and 49 cases had no postoperative complications.Single factor analysis result showed that the proportion of patients with age≥60 years old,drinking,BMI<18.5 kg/m^(2),preoperative complications and preoperative long-term bed rest in the observation group were higher than those in the control group,and the proportion of patients with postoperative functional exercise was lower than that in the control group(P<0.05).Multivariate Logistic regression analysis result showed that age,drinking,BMI,preoperative complications and preoperative long-term bed rest were independent risk factors for complications after internal fixation of femoral intertrochanteric fracture in the middle-aged and elderly(P<0.05).After improvement,the specificity and accuracy of POSSUM scoring system in predicting complications after internal fixation of femoral intertrochanteric fractures in middle-aged and elderly were higher than those before improvement(P<0.05).Conclusion Age≥60 years old,drinking,BMI<18.5 kg/m^(2),preoperative complications and preoperative long-term bed rest are independent risk factors for complications after internal fixation of femoral intertrochanteric fracture in the middle-aged and elderly.The POSSUM scoring system after improvement has a higher predictive value for postoperative complications.
作者
张宏蕾
李佳
孙晴
ZHANG Honglei;LI Jia;SUN Qing(Orthopedics and Traumatology Department,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710016,China)
出处
《临床医学研究与实践》
2021年第23期20-22,共3页
Clinical Research and Practice
基金
陕西省重点研发计划项目(No.2019SF-282)。
关键词
中老年
股骨粗隆间骨折内固定术
POSSUM评分系统
术后并发症
middle-aged and elderly
internal fixation of femoral intertrochanteric fracture
POSSUM scoring system
postoperative complications
