中国骨伤2023，Vol.36Issue(12)：1114-1119,6.DOI:10.12200/j.issn.1003-0034.2023.12.002
髋部骨折后术前心力衰竭危险因素及预后分析
Risk factors and prognosis of preoperative herat failure after hip fracture
摘要
Abstract
Objective To explore incidence,risk factors and the relationship between preoperative heart failure and prog-nosis in elderly patients with hip fracture.Methods A retrospective analysis was performed on 1 569 elderly patients with hip fracture treated from January 2012 to December 2019,including 522 males and 1 047 females,aged 81.00(75.00,90.00)years old;896 intertrochanteric fractures and 673 femoral neck fractures.Patients were divided into heart failure and non-heart failure groups according to whether they developed heart failure before surgery,and heart failure was set as the dependent vari-able,with independent variables including age,gender,fracture type,comorbidities and hematological indicators,etc.Univari-ate analysis was performed at first,and independent variables with statistical differences were included in multivariate Logistic regression analysis.Independent risk factors for preoperative heart failure were obtained.The length of hospital stay,periopera-tive complications,mortality at 30 days and 1 year after surgery were compared between heart failure and non-heart failure groups.Results There were 91 patients in heart failure group,including 40 males and 51 females,aged 82.00(79.00,87.00)years old;55 patients with intertrochanteric fracture and 36 patients with femoral neck fracture.There were 1 478 patients in non-heart failure groups,including 482 males and 996 females,aged 81.00(75.00,86.00)years old;841 patients with in-tertrochanteric fracture and 637 patients with femoral neck fracture.There were significant differences in age,sex,coronary heart disease,arrhythmia and dementia between two groups(P＜0.05).Multivariate Logistic analysis of statistically significant factors showed that males(OR=1.609,P=0.032),age(OR=1.032,P=0.031),arrhythmia(OR=2.045,P=0.006),dementia(OR=2.106,P=0.014)were independent risk factor for preoperative heart failure.The 30-day and 1-year mortality rates were 9.9％and 26.4％in heart failure group and 3.6％and 13.8％in non-heart failure group,respectively;and had statistical signifi-cance between two groups(P＜0.05).There were significant differences in pulmonary infection,cerebrovascular complications and cardiovascular complications between two groups(P＜0.05).The duration of hospitalization in heart failure group was(16.21±10.64)d compared with that in non-heart failure group(13.26±8.00)d,and the difference was statistically significant(t=2.513,P=0.012).Conclusion Male,old age,arrhythmia and dementia are independent risk factors for heart failure after hip fracture in elderly patients.Patients with preoperative heart failure have a higher incidence of postoperative pulmonary infec-tion,cerebrovascular and cardiovascular complications,higher mortality at 30 d and 1 year after surgery,and longer hospital stay.关键词
老年/髋部骨折/心力衰竭Key words
Elderly/Hip fracture/Heart failure分类
医药卫生引用本文复制引用
郭艳辉,王晔来,孙天胜,刘智,张建政,王晓伟..髋部骨折后术前心力衰竭危险因素及预后分析[J].中国骨伤,2023,36(12):1114-1119,6.基金项目
北京市自然科学基金(编号:7232165)Beijing Natural Science Foundation(No.7232165) （编号:7232165）
