文章摘要
吴永光,胡玄,全炜琨,等.骨质疏松性髋部骨折一年内死亡的危险因素分析.骨科,2018,9(1): 32-36.
骨质疏松性髋部骨折一年内死亡的危险因素分析
Analysis of risk factors for the death within one year in patients with osteoporotic hip fractures
投稿时间:2017-06-19  
DOI:10.3969/j.issn.1674-8573.2018.01.007
中文关键词: 骨质疏松性骨折    骨折  死亡  危险因素
英文关键词: Osteoporotic fractures  Hip  Fractures, bone  Death  Risk factors
基金项目:
作者单位E-mail
吴永光 430100 武汉武汉市蔡甸区人民医院骨科  
胡玄 430100 武汉武汉市蔡甸区人民医院骨科 wyg_2009@yeah.net 
全炜琨 430100 武汉武汉市蔡甸区人民医院骨科  
王炯 430100 武汉武汉市蔡甸区人民医院骨科  
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中文摘要:
      目的 探讨骨质疏松性髋部骨折1年内死亡的独立危险因素。方法 回顾性分析2012年1月至2016年5月我院收治的226例骨质疏松性髋部骨折病人的临床资料,收集病人的性别、年龄、身体质量指数(body mass index, BMI)、基础疾病情况、是否单独居住、日常生活能力评分、骨密度T值、骨折类型、受伤至手术时间、治疗方式、手术方式、麻醉方式、美国麻醉医师协会(American Society of Anesthesiology, ASA)分级以及术前实验室检查指标等临床资料,先后进行单因素分析和多因素Logistic回归分析。结果 1年随访期内,有33例(14.60%)病人死亡,根据病人是否死亡分为死亡组(33例)和生存组(193例)。单因素分析结果显示年龄、性别、基础疾病种类数、慢性肺病、贫血、痴呆、单独居住、日常生活能力评分、骨折至手术时间、治疗方式、全身麻醉、ASA分级以及入院时淋巴细胞、血清白蛋白、血红蛋白、肌酐和骨密度与骨质疏松性髋部骨折1年内死亡相关(P<0.05)。多因素Logistic回归分析结果表明高龄(OR=2.48,P=0.006)、男性(OR=1.53,P=0.016)、合并基础病种类数≥3类(OR=2.52,P=0.024)、共患慢性肺病(OR=1.74,P=0.017)、共患痴呆(OR=1.21,P=0.025)、日常生活能力评分低(OR=1.61,P=0.014)、ASA分级为Ⅲ~Ⅳ级(OR=1.36,P=0.033)、血清白蛋白水平低(OR=1.30,P=0.041)以及保守治疗方式(OR=1.21,P=0.012)是骨质疏松性髋部骨折1年内死亡的独立危险因素。结论 对于高龄、男性、合并基础疾病类数≥3类、患慢性肺病、痴呆、日常生活能力评分低、ASA分级为Ⅲ~Ⅳ级、血清白蛋白水平低以及保守治疗方式的骨质疏松性髋部骨折病人应予以重视,全面评估病人的身体机能和健康状况,制定合适的治疗方案。
英文摘要:
      Objective To explore the independent risk factors for the death of osteoporotic hip fractures within 1 year. Methods The clinical data of 226 patients with osteoporotic hip fractures in our hospital from January 2012 to May 2016 were obtained. Gender, age, body mass index (BMI), basic diseases, living alone, ADL score, bone mineral density, fracture type, duration from injury to surgery, treatment, surgery, anesthesia, American Society of Anesthesiologists (ASA) classification and preoperative laboratory indexes were collected, and the univariate and multivariate analysis was applied. Results Of the 226 patients, 33 died during the 1-year follow-up period, with a mortality rate of 14.60%. Univariate analysis showed that age, sex, number of basic diseases, combined chronic lung disease, combined dementia, living alone, activity of daily living scores, duration from fracture to surgery, treatment strategies, general anesthesia, ASA classification, lymphocyte count at admission, albumin levels, hemoglobin levels, creatinine levels and bone mineral density were risk factors for death within 1 year in patients with osteoporotic hip fractures (P<0.05 for all). Multivariate Logistic regression analysis showed that aged (OR=2.48, P=0.006), male (OR=1.53, P=0.016), more than 3 basic diseases (OR=2.52, P=0.024), combined chronic lung disease (OR=1.74, P=0.017), combined dementia (OR=1.21, P=0.025), lower activity of daily living scores (OR=1.61, P=0.014), conservative treatment (OR=1.21, P=0.012), ASA Ⅲ-Ⅳ (OR=1.36, P=0.033), and albumin levels (OR=1.30, P=0.041) were the independent risk factors for death within 1 year in patients with osteoporotic hip fractures. Conclusion The patients of aged, male, number of basic diseases more than 3, chronic lung disease, dementia, lower daily living ability scores, ASA Ⅲ-Ⅳ, lower serum albumin level and conservative treatment should be given more attention and comprehensive evaluation, for the appropriate treatment plan.
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