发生骨折后并发症的危险因素
En Lin Goh1, May Ee Png2, David Metcalfe1
1Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Research Centre, University of Oxford, Oxford, UK.
这项研究确定了骨折并发症的关键风险因素. 年龄较大,男性性别较高,并发病率较高会增加并发症的风险,而延迟手术和动员等可修改因素也起着重要作用.
科学领域:
- 骨科手术
- 老年医学
- 公共卫生
背景情况:
- 骨折死亡率有所下降, 但并发症率仍然很高.
- 确定影响骨折后并发症的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 确定骨折后并发症的不可修改和可修改因素.
- 为减少关节骨折后发病率提供有针对性的干预措施.
主要方法:
- 多中心前性队列研究,对24523名患有骨折的60岁或以上的成年人进行.
- 用于评估120天后与手术特异性和一般性并发症相关的Cox比例危险回归模型.
主要成果:
- 非可改变的因素:男性性别,美国麻醉学会 (ASA) 级别≥III,年龄增加与各种并发症有关.
- 可改变的因素:延迟动员和延迟手术与急性损伤 (AKI),下呼吸道感染 (LRTI),心肌梗塞 (MI) 和肺栓塞 (PE) 的风险增加有关.
- 特定的手术因素:用头骨钉或关节整形手术 (THA) 的治疗与特定的手术并发症有关.
结论:
- 与患者相关的因素如年龄,性别和并发症有助于更高的并发症率和更糟糕的恢复.
- 确定了可能改变的与治疗相关的因素,需要进一步研究干预策略.
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