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| 老年髋部骨折患者术后心血管并发症的危险因素分析 |
| Analysis on risk factors of postoperative cardiovascular complications in the elderly patients with hip fracture |
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| DOI：10.12089/jca.2018.03.003 |
| 中文关键词: 老年患者 髋部骨折 术后并发症；危险因素 |
| 英文关键词: Aged Hip fracture Postoperative complication Risk factors |
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| 中文摘要: |
| 目的 探讨老年髋部骨折患者住院期间术后新发心血管并发症的危险因素。方法 回顾性分析本院骨科2005年1月至2015年12月收治的髋部骨折患者693例, 男257例, 女436例, 年龄65～103岁，BMI 16.5～33.1 kg/m2, ASA Ⅱ～Ⅳ级, 分别收集患者的人口学资料、术前合并症、卧床时间、手术方式、麻醉方法 、手术时间和出血量, 采用多因素Logistic回归模型分析老年髋部骨折患者住院期间术后新发心血管并发症的危险因素。结果 46例患者(6.64％)在住院期间发生术后心血管并发症, 包括心绞痛25例(3.61％)、心律失常19例(2.74％)、心力衰竭5例(0.72％)、心肌梗死4例(0.58％)和心源性猝死2例(0.29％)。单因素分析显示，年龄、心脏疾病、脑血管疾病、高血压、糖尿病、肾功能不全和全麻方式是老年髋部骨折患者住院期间新发术后心血管并发症的相关危险因素(P<0.05)。多因素Logistic回归分析显示年龄(OR=1.11, 95％ CI 1.06～1.17, P＜0.001)、心脏疾病(OR=1.98, 95％ CI 1.02～3.85, P=0.045)、脑血管疾病(OR=2.14, 95％ CI 1.06～4.32, P=0.033)、高血压(OR=2.61, 95％ CI 1.23～5.51, P=0.012)、糖尿病(OR=2.06, 95％ CI 1.04～4.09, P=0.039)和肾功能不全(OR=17.42, 95％ CI 3.69～82.80, P＜0.001)是髋部骨折患者住院期间术后新发心血管并发症的独立危险因素。结论 年龄、心脏疾病、脑血管疾病、高血压、糖尿病和肾功能不全可作为老年髋部骨折患者住院期间新发心血管并发症的预警因素。 |
| 英文摘要: |
| Objective To investigate the risk factors of postoperative cardiovascular complications in elderly patients with hip fracture during hospitalization. Methods A retrospective analysis was conducted according to the medical records of 693 elderly patients with hip fracture admitted to our hospital from January, 2005 to December, 2015. There were 257 males and 436 females, aged 65-103 years and body mass index (BMI) 16.5-33.1 kg/m2, ASA physical status Ⅱ-Ⅳ. The demographic data, preoperative comorbidities, time before surgery, surgical types, anesthetic methods, operation time and blood loss were recorded. Multivariate logistic regression analysis was applied to analyze the risk factors of postoperative cardiovascular complications in elderly patients with hip fracture during hospitalization. Results Postoperative cardiovascular complications occurred in 46 (46/693, morbidity: 6.64％), including angina pectoris, arrhythmia, heart failure, myocardial infarction and sudden cardiac death. Univariate analysis showed that the independent variables of postoperative cardiovascular complications were age, cardiac comorbidities, hypertention, diabetes mellitus, cerebrovascular disease, renal insufficiency and anesthetic methods (P＜0.05). Multiple logistic regression analysis showed that age (OR=1.11, 95％ CI 1.06-1.17, P＜0.001), cardiac comorbidities (OR=1.98, 95％ CI 1.02-3.85, P=0.045), hypertention (OR=2.61, 95％ CI 1.23-5.51, P=0.012), diabetes mellitus (OR=2.06, 95％ CI 1.04-4.09, P=0.039), cerebrovascular disease (OR=2.14, 95％ CI 1.06-4.32, P=0.033) and renal insufficiency (OR=17.42, 95％ CI 3.69-82.80, P＜0.001) were independent risk factors for postoperative cardiovascular complications in elderly patients with hip fracture during hospitalization. Conclusion Age, cardiac comorbidities, hypertention, diabetes mellitus, cerebrovascular disease and renal insufficiency are independent predictors for postoperative cardiovascular complications in elderly patients with hip fracture during hospitalization. |
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