在老年人部骨折手术后的长期存活期的术前等待时间
Chunyuan X Qiu1, Priscilla H Chan2, Kathryn E Royse2
1Department of Anesthesiology, Kaiser Permanente, Baldwin Park, CA 91706, USA.
Geriatrics (Basel, Switzerland)
|November 24, 2025
概括
对于没有服用抗凝血药物的老年关节骨折患者,在6-15小时内进行手术将死亡率降至最低. 超过24小时的等待时间对这些患者的死亡率没有进一步的影响.
科学领域:
- 老年医学 老年医学
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 高龄的关节骨折患者面临高的第一年术后死亡率 (15-36%).
- 手术前的等待时间影响关节骨折患者的发病率和死亡率.
- 基于抗凝血状态的最佳手术时间尚不清楚.
研究的目的:
- 根据抗凝血状态来确定骨骨折修复的理想手术前等待时间.
- 分析手术等待时间对老年关节骨折患者手术后发病率和死亡率的影响.
- 确定针对服用抗凝血剂的患者和不服用抗凝血剂的患者的具体时间建议.
主要方法:
- 从美国部骨折登记处 (2009-2019) 分析了35463名65岁以上的患者.
- 基于在手术后100天内使用手术前抗凝剂 (AC) 的患者分层.
- 多变量逻辑回归使用立方线来建模非线性等待时间趋势.
主要成果:
- 87.1%的患者没有接受手术前的AC,平均等待时间为20.3小时.
- 在非AC患者中观察到等待时间和死亡率之间的正线性趋势.
- 手术前AC患者的死亡率呈现"U"形趋势,尽管在统计学上并不显著.
结论:
- 在入院6-15小时内手术的非AC患者中,短期死亡率最低.
- 在前24小时内,非AC患者的死亡率保持一致.
- 这些发现支持优化基于关骨折患者手术前AC使用的外科手术期间协议.
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