| 戚鸿飞,任程,马腾,等.影响老年髋部骨折病人术后自理能力恢复的危险因素分析.骨科,2021,12(1): 51-55. |
| 影响老年髋部骨折病人术后自理能力恢复的危险因素分析 |
| Risk factors influencing the recovery of self-care ability after operation in elderly patients with hip fracture |
| 投稿时间：2020-04-04 |
| DOI：10.3969/j.issn.1674-8573.2021.01.010 |
| 中文关键词: 髋部骨折 自理能力 危险因素分析 |
| 英文关键词: Hip fractures Self-care ability Risk factor analysis |
| 基金项目:陕西省自然科学基金（2016JM8151） |
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| 中文摘要: |
| 目的 探讨影响老年髋部骨折病人术后自理能力恢复的危险因素。方法 回顾性分析西安交通大学医学院附属红会医院2017年6月至2018年12月收治的195例老年髋部骨折病人的临床资料，并通过门诊复查、电话询问和社区走访等方式获取病人术后康复信息，根据病人术后1年的Barthel指数将病人分为不能自理组（Barthel指数评分≤60分）和基本自理组（Barthel指数评分＞60分）。先采用单因素分析筛选危险因素，再通过多因素Logistic回归确定独立危险因素。结果 195例病人中，不能自理组65例，基本自理组130例。单因素分析显示年龄、美国麻醉医师协会（America Society of Anesthesiologists，ASA）分级、术前合并内科疾病种类、受伤至手术时间、术前血浆白蛋白、血红蛋白、居住环境、术后是否行抗骨质疏松治疗、术后是否于康复机构康复均与老年髋部骨折术后自理能力恢复有关（P均＜0.05）；多因素Logistic回归分析显示高龄［OR=1.326，95% CI（1.036，1.096），P=0.025］是老年髋部骨折病人术后自理能力恢复的独立危险因素，术前血浆白蛋白高［OR=0.543，95% CI（0.276，0.895），P=0.002］、居住环境为农村［OR=0.225，95% CI（0.076，0.462），P=0.007］、术后抗骨质疏松治疗［OR=0.647，95% CI（0.427，0.947），P=0.002］、术后在康复机构康复［OR=0.438，95% CI（0.229，0.835），P＜0.001］是老年髋部骨折病人术后自理能力恢复的保护因素。结论 对高龄、术前白蛋白低的病人应加强干预；术后抗骨质疏松治疗以及在康复机构康复对老年髋部骨折病人术后自理能力的恢复有一定积极作用。 |
| 英文摘要: |
| Objective To investigate the risk factors influencing the recovery of self-care ability after operation in elderly patients with hip fracture. Methods Data of 195 elderly hip fracture patients admitted from June 2017 to December 2018 in Honghui Hospital were retrospectively analyzed. the postoperative rehabilitation information was obtained through outpatient review, telephone inquiry and community visits. The patients were divided into the non self-care group (Barthel index score ≤60 points; 65 cases) and the basic self-care group (Barthel index score ＞60 points; 130 cases) according to the Barthel index scale. Single factor analysis was used to screen for risk factors, and then independent risk factors were determined by multivariate Logistic regression. Results Univariate risk factor analysis showed age, America Society of Anesthesiologists (ASA), type of medical disease before surgery, time from injury to operation, plasma albumin and hemoglobin before surgery, living condition, whether anti-osteoporosis treatment was performed after surgery, and whether rehabilitation in rehabilitation institutions were associated with the recovery of self-care ability after hip fracture operation (all P＜0.05). Multivariate Logistic regression analysis showed that advanced age ［OR=1.326, 95% CI (1.036, 1.096), P=0.025] was independent risk factor for the recovery of self-care ability in elderly hip fractures. High preoperative plasma albumin ［OR=0.543, 95% CI (0.276, 0.895), P=0.002], living in the county［OR=0.225, 95% CI (0.076, 0.462), P=0.007], anti-osteoporosis treatment after surgery ［OR=0.647, 95% CI (0.427, 0.947), P=0.002], rehabilitation in rehabilitation institutions ［OR=0.438, 95% CI (0.229, 0.835), P＜0.001] were the protective factors for the recovery of self-care ability. Conclusion The intervention should be strengthened for the elderly patients with low preoperative albumin, and the postoperative anti-osteoporosis treatment and rehabilitation in rehabilitation institutions play a positive role in the recovery of self-care ability of elderly hip fracture. |
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