贫血在老年人关节骨折中的后果:有多低是太低?
Kimberli Bruce1, Alicia Mangram1, Joseph F Sucher1
1Trauma Services, HonorHealth John C Lincoln Medical Center, Phoenix, Arizona, USA.
Trauma surgery & acute care open
|February 14, 2024
概括
在老年关节骨折患者中,最低血红蛋白水平为7.1g/dL或更低与更不利的结果有关. 这种风险在79岁以上的患者中更高.
科学领域:
- 老年医学 老年医学
- 创伤外科 手术 创伤外科
- 血液学 血液学 血液学
背景情况:
- 在患有骨骨折的老年患者中,低血红蛋白 (Hgb) 的最佳输血门仍然是争论的主题.
- 在特定患者群体中,低Hgb水平与较差的健康结果有关.
- 这项研究的目的是确定Hgb的值,在这个人群中不良结果变得更频繁.
研究的目的:
- 评估在老年关节骨折患者中记录的最低血红蛋白水平和患者结局之间的关系.
- 为了确定特定的血红蛋白值,与较高的不良结果的流行率相关.
- 为老年关节骨折患者提供输血指南.
主要方法:
- 在两个1级创伤中心 (2018-2021) 进行了60岁以上的关节骨折患者的回顾性队列研究.
- 排除标准包括非操作性固定或停留时间小于1天.
- 主要终点:心肌梗塞,中风,新发性心律失常或死亡的组合. 用分类和回归树 (CART) 分析来确定Hgb值.
主要成果:
- 分析了935名患者;平均年龄为80±10岁.
- 在6.1%的患者中发生了不良结局.
- 卡特分析确定最低Hgb≤7.1g/dL作为增加不良结果的门 (15%对4.1%,p<0.001).
- 高龄患者 (>79岁) 的Hgb≤7.1g/dL的不良结局率为22%.
- 最低Hgb≤7.1g/dL在多变量分析后仍然是不良结果的重要风险因素.
结论:
- 最低血红蛋白水平≤7.1g/dL显着与患有部骨折的老年患者的不良结果增加有关.
- 这种风险在79岁以上的患者中尤为明显.
- 临床医生应对这种人口群体保持谨慎,并在输血决策中考虑这种Hgb值.
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