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对于老年人的脚骨折,是否有最佳的外科风险评估工具?

Nicole Huang¹, Teresa Cheng², Cara Joyce³

¹Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S First Ave, Maywood, IL, 60153, USA. nicole.huang@luhs.org.

Archives of orthopaedic and trauma surgery

|December 21, 2024

概括

国家外科质量改善计划 (NSQIP) 最好预测脚骨折的老年人的并发症. 然而,没有一项经过测试的风险评估工具显示出对这些特定伤害的优异预测性能.

科学领域:

整形外科手术整形外科手术
老年创伤的治疗方法
手术结果研究研究.

背景情况:

患有脚骨折的老年人面临着术后并发症的重大风险.
准确预测这些并发症对于优化患者护理和手术决策至关重要.
现有的术后风险评估工具需要对这种特定患者群体进行评估.

研究的目的:

评估三个风险评估工具的预测准确性:国家外科质量改善计划 (NSQIP),修改的5因素脆弱性指数 (mFI-5) 和老年和中年人的创伤选分数 (STTGMA).
确定这些工具在预测患有孤立脚骨折的老年人手术后并发症和死亡率方面的有效性.

主要方法:

在2007年至2022年间,对382个经过手术治疗的老年人骨骨折 (年龄≥55岁) 进行了回顾性分析.
收集的数据包括患者人口统计,损伤特征,临床结果和并发症.
使用了NSQIP,mFI-5和STTGMA计算器;使用接收器操作特征曲线 (AUC) 下面的面积来评估预测性能.

主要成果:

该研究包括382名患者,平均年龄为67岁;23.6%的患者至少出现了一种并发症.
对于任何并发症,NSQIP的预测值最高 (AUC为0.74),其次是STTGMA (AUC为0.72) 和mFI-5 (AUC为0.68).
一年内死亡率为2.9%,与其他工具相比,NSQIP显示出优异的预测.

结论:

在老年人骨骨折的风险评估工具中,NSQIP工具在预测术后并发症和死亡率方面表现最好.
尽管NSQIP的性能优异,但没有一个评估的工具在老年人群中实现了对这种特定骨折类型的良好预测准确度.
进一步完善风险分层工具是有必要的老年人维持孤立的脚骨折.

关键词:

脚骨折脚骨折在脚骨折老年人脚骨折的情况老年创伤患者的创伤风险计算器风险计算器

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