90 岁以上股骨粗隆间骨折2年生存调查

2-year survival of intertrochanteric fracture of femur over 90 years old

摘要:

目的：探讨高龄股骨粗隆间骨折伤后的生存情况及死亡的危险因素 方法： 回顾性分析 2016 年 1 月—2023 年 3 月在本院住院并行手术治疗的172例老年患者，通过对病历资料的回溯获得一般信息、术前化验及手术相关资料，上述病人全部采取了髓内针固定或人工股骨头置换术治疗，通过电话随访获得患者的生存结局，采用单因素分析、Cox 比例风险回归模型及 K-M 分析筛查与死亡有关的危险因素。 结果：随访时间为 1-87 个月，生存时间6个月、12个月、24个月分别死亡27例（15.70%） 、死亡53例（30.81%）、102例（59.30%），其6个月生存率为 84.30% ，12月生存率为69.19% ，24个月生存率仅为 40.70%。单因素分析显示：与生存组相比，死亡组的BMI显著小，ASA分级显著高，术前Hb水平显著低，Cox 风险回归模型的结果显示：男性、较小的BMI 值、ASA IV级、A3型骨折是死亡的危险因素。 结论：对于高龄股骨粗隆间骨折的病人，其术后死亡率尤其是24个月死亡率较高，同时男性、较小的BMI 值、ASA IV级、A3型骨折是死亡的危险因素。

Abstract:

[Objective]: To investigate the survival and risk factors of death in elderly patients with intertrochanteric fracture of femur[Methods]A retrospective analysis was conducted on 172 elderly patients admitted to our hospital for concurrent surgical treatment from January 2016 to March 2023. General information, preoperative laboratory tests and surgical information were obtained through retrospective analysis of medical records. All of the above patients were treated with intramedullary needle fixation or artificial femoral head replacement. Univariate analysis, Cox proportional hazard regression model and K-M analysis were used to screen for risk factors associated with death.[Result] The follow-up time was 1-87 months, and the survival time was 6 months, 12 months and 24 months, respectively, with 27 deaths (15.70%), 53 deaths (30.81%) and 102 deaths (59.30%). The 6-month survival rate was 84.30% and the 12-month survival rate was 69.19%. The 24-month survival rate was only 40.70%. Univariate analysis showed that compared with the survival group, BMI in the death group was significantly lower, ASA grade was significantly higher, and preoperative Hb level was significantly lower. Results of Cox risk regression model showed that male, small BMI value, ASA grade IV, and A3 fracture were risk factors for death.[Conclusions] Postoperative mortality is higher in older patients with intertrochanteric fractures, especially at 24 months. Male, small BMI, ASA grade IV, and A3 fractures are risk factors for death. comorbidities are risk factors for death.