Risk factors related to mortality at one year after surgery for intertrochanteric fracture in the elderly

doi:10.3877/cma.j.issn.2096-0263.2018.05.005

Abstract

Abstract:

Objective

To analyse risk factors related to mortality at one year after surgery for intertrochanteric fracture in the elderly.

Methods

Records of patients undergoing surgery at our hospital between January 2015 andJanuary2017 were retrospectively reviewed. By telephone follow up, the health condition of each patient was surveyed, and one year postoperative mortality was analyzed. The age, gender, fracture type, presence of chronic diseases at admission, time between fracture and surgery, and preoperative laboratory examination results were analyzed. Univariateand multivariate regression analyses were performed on relevant influencing factors.

Results

Complete data were available for a total of 161 patients who were followed up for 12-24 months (age≥60 years). There were 20 deaths (12.4%) at one year. Univariate analysis revealed that factors such as fracture type, chronic obstructive pulmonary disease, diabetes, number of preoperative diseases, preoperative albumin, and preoperative alanine amino transferase differed significantly between survival and death groups (P<0.05). Multivariate regression analysis revealed that chronic obstructive pulmonary disease, diabetes, and preoperative albumin were independent risk factors for death (P<0.05).

Conclusions

Taking full consideration of risk factors in the treatment of intertrochanteric fracture in the elderly, selecting appropriate anesthesia and treatment methods, improving preoperative health conditions may reduce the one-year mortality and facilitate functional recovery after surgery.

Key words: Aged, Hip fractures, Mortality, Risk factors

Yu Zhang, Xiaodong Qin, Yiqi Xu, Wenjun Xie, Jun Hu. Risk factors related to mortality at one year after surgery for intertrochanteric fracture in the elderly[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(05): 277-281.

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References 18

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组别	例数	年龄		性别		骨折AO分型		术前合并疾病				术前合并疾病数量
组别	例数	≤80岁	>80岁	男性	女性	A1	A2+A3	高血压	脑部疾患	慢性阻塞性肺病	糖尿病	≤2种	>2种
存活组	141	65	76	48	93	76	65	50	20	20	5	134	7
死亡组	20	9	11	8	12	4	16	12	4	8	4	16	4
χ²值	?	0.008		0.274		8.052		4.451	0.227	8.125	8.985	6.220
P值	?	0.926		0.601		<0.05		<0.05	<0.01	<0.01	?	<0.05
组别	例数	受伤至手术时间		血红蛋白浓度（g/L）		白细胞数（10^9/L）		白蛋白（g/L）		血钾（mmol/L）		尿素氮（mmol/L）		丙氨酸氨基转移酶（U/L）
组别	例数	≤2 d	>2 d	≥110	<110	≥9.5	<9.5	≥35	<35	≥4.5	正常范围	≥9	<9	≥50	正常范围
存活组	141	22	119	47	94	56	85	77	64	20	121	21	120	7	134
死亡组	20	4	16	3	17	6	14	3	17	4	16	4	16	5	15
χ²值	?	0.250		2.750		0.698		10.993		0.467		0.348		10.193
P值	?	0.617		0.097		0.403		<0.01		0.494		0.561		<0.01

组别	例数	年龄		性别		骨折AO分型		术前合并疾病				术前合并疾病数量
组别	例数	≤80岁	>80岁	男性	女性	A1	A2+A3	高血压	脑部疾患	慢性阻塞性肺病	糖尿病	≤2种	>2种
存活组	141	65	76	48	93	76	65	50	20	20	5	134	7
死亡组	20	9	11	8	12	4	16	12	4	8	4	16	4
χ²值	?	0.008		0.274		8.052		4.451	0.227	8.125	8.985	6.220
P值	?	0.926		0.601		<0.05		<0.05	<0.01	<0.01	?	<0.05
组别	例数	受伤至手术时间		血红蛋白浓度（g/L）		白细胞数（10^9/L）		白蛋白（g/L）		血钾（mmol/L）		尿素氮（mmol/L）		丙氨酸氨基转移酶（U/L）
组别	例数	≤2 d	>2 d	≥110	<110	≥9.5	<9.5	≥35	<35	≥4.5	正常范围	≥9	<9	≥50	正常范围
存活组	141	22	119	47	94	56	85	77	64	20	121	21	120	7	134
死亡组	20	4	16	3	17	6	14	3	17	4	16	4	16	5	15
χ²值	?	0.250		2.750		0.698		10.993		0.467		0.348		10.193
P值	?	0.617		0.097		0.403		<0.01		0.494		0.561		<0.01

影响因素	β	标准误	Wald值	OR（95% CI）	P值
骨折AO分型	1.141	0.686	1.631	3.112（0.857～13.951）	0.102
高血压	0.706	0.652	1.068	2.01（0.555～7.513）	0.281
慢性阻塞性肺病	1.751	0.743	2.367	5.777（1.314～25.753）	<0.05
糖尿病	2.522	0.927	2.732	12.426（2.083～85.910）	<0.05
术前合并疾病数量	0.065	1.056	0.051	1.068（0.136～8.673）	0.963
血红蛋白浓度（g/L）	-0.028	0.025	-1.381	0.970（0.931～1.014）	0.171
白蛋白（g/L）	-0.208	0.076	-2.612	0.974（0.934～1.016）	<0.05
丙氨酸氨基转移酶（U/L）	-0.012	0.014	-1.218	0.991（0.966～1.004）	0.235

影响因素	β	标准误	Wald值	OR（95% CI）	P值
骨折AO分型	1.141	0.686	1.631	3.112（0.857～13.951）	0.102
高血压	0.706	0.652	1.068	2.01（0.555～7.513）	0.281
慢性阻塞性肺病	1.751	0.743	2.367	5.777（1.314～25.753）	<0.05
糖尿病	2.522	0.927	2.732	12.426（2.083～85.910）	<0.05
术前合并疾病数量	0.065	1.056	0.051	1.068（0.136～8.673）	0.963
血红蛋白浓度（g/L）	-0.028	0.025	-1.381	0.970（0.931～1.014）	0.171
白蛋白（g/L）	-0.208	0.076	-2.612	0.974（0.934～1.016）	<0.05
丙氨酸氨基转移酶（U/L）	-0.012	0.014	-1.218	0.991（0.966～1.004）	0.235

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