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延迟手术固定与患有远端大腿骨骨折的患者的死亡率增加有关

Muhammad Umar Jawad¹, Leeann M Qubain¹, Haroon M Kisana²

¹Department of Orthopedic Surgery, University of Arizona College of Medicine - Phoenix, Banner University Medical Center - Phoenix, 1320 N 10th St. Suite A, Phoenix, AZ 85006, USA.

|May 24, 2025

概括

偏远大腿骨折的早期手术固定显著降低了30天死亡风险. 推迟手术增加了死亡率,突出了对这些骨折及时干预的重要性.

科学领域:

整形外科手术整形外科手术
创伤外科手术创伤外科
医疗保健服务研究医疗服务研究

背景情况:

关于距离骨骨折中手术干预的最佳时间存在相互矛盾的证据.
术前的时间对这些伤害患者的结果的影响在文献中尚不清楚.

研究的目的:

研究患有远端股骨骨折的患者手术固定时间和30天死亡率之间的关联.
为了澄清早期与延迟手术和患者结果之间的关系.

主要方法:

美国外科医生学院国家外科质量改进项目 (NSQIP®) 数据库 (2010-2021) 的回顾性审查.
包括需要手术固定或关节整形的本地和周围假肢远端股骨骨折.
医院0或1日 (HD ≤ 1) 的手术与医院1日 (HD > 1) 之后的手术结果的比较,以30天死亡率为主要结局.

主要成果:

总共分析了6857例病例,其中84.5%的病例在HD≤1的情况下接受了手术.
对HD ≤ 1进行手术与对HD> 1进行手术相比,30天死亡率下降40% (OR 0.587; p = 0.031).
多变量分析确定呼吸障碍,手术前输血和出血障碍是死亡风险因素,而年轻的年龄显示出保护作用.

结论:

偏远大腿骨折的延迟手术固定与30天死亡率的增加有关.
需要进一步的研究来确定死亡率的增加是否直接归因于手术延迟或其他未测量的混变量.

关键词:

30天死亡率30天死亡率距离大腿骨骨折骨折距离大腿骨骨折脆弱性骨折是一种脆弱性骨折.周围的假肢骨折是指周围的假肢骨折.对手术的时间安排.

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Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...