在老年人靠近大腿骨骨折中的心脏优化
Sadhin Subhash1, Paul Njoku2, Shahtajarab Saltanat3
1Trauma and Orthopaedics, East Suffolk and North Essex NHS Foundation Trust, Ipswich, GBR.
Cureus
|September 29, 2025
概括
老年关节骨折患者面临高死亡率的心脏问题,如术后心房动 (POAF). 优化心脏护理,包括管理心力衰竭和设备问题,对于更好的结果至关重要.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 整形外科手术 整形外科手术
背景情况:
- 脆弱性关节骨折在老年人中很常见,导致显著的发病率和死亡率.
- 心血管并发症使这些患者的结果变得更糟.
- 术后心脏并发症是关节骨折修复的一个主要问题.
研究的目的:
- 审查老年患者患有脆弱性关节骨折的术后心脏并发症.
- 评估心脏护理的优化策略,重点关注特定的并发症.
- 强调手术后心房动 (POAF),急性心肌梗塞 (AMI),心力衰竭和心脏植入式电子设备 (CIED) 的管理.
主要方法:
- 进行了PubMed,Embase和Cochrane图书馆文献的叙事审查 (2000年1月至2024年3月).
- 包括NICE,ESC和ACC/AHA的相关指南.
- 使用与关节骨折,心脏并发症和特定心脏病状况/设备相关的搜索术语.
主要成果:
- 手术后心房动 (POAF) 影响约3-4%的老年关节骨折患者,显著增加一年死亡率 (60%与19.5%相比).
- 患POAF的危险因素包括手术延迟超过48小时和超过2单位的红细胞输血.
- 由于异常表现,急性心肌梗塞 (AMI) 和心力衰竭往往被诊断不足;CIED管理需要多学科协调.
结论:
- 由于证据有限和实践多样化,老年关节骨折患者的心脏优化具有挑战性.
- 开发经过验证的POAF风险预测工具至关重要.
- 需要标准化的协议和多学科的途径来改善结果和减少医疗保健负担.
相关概念视频
Fractures: Bone Repair
5.1K
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...
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...
5.1K
Bones of the Lower Limb: Femur and Patella
4.8K
The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
4.8K
Heart Failure V: Medical Management
223
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
223
Cardiac Catheterization IV: Nursing Management
656
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
656


