影响部骨折手术后死亡率的因素:一级创伤中心长期研究的见解 - 时间是否重要?
Lukas L Negrin1, Thomas Christian1, Sandra Kalus1
1Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria.
Journal of clinical medicine
|November 27, 2025
概括
关节骨折手术的时间不是死亡率的独立预测指标. 手术延迟与死亡率相关,但可能反映了伴随性疾病相关的选择,而不是直接的因果关系.
科学领域:
- 创伤外科手术是什么
- 整形外科手术 整形外科手术
- 老年医学 老年医学
背景情况:
- 手术前住院时间 (PLHS) 是关节骨折手术中的可修改因素.
- 最佳的手术时间对于降低死亡风险至关重要.
研究的目的:
- 探索PLHS与部骨折患者在六年内全因死亡率之间的关联.
- 确定该患者队列中死亡率的独立预测因素.
主要方法:
- 对2015-2018年接受手术的成年关节骨折患者的回顾性研究.
- PLHS分为四组:≤24小时,24-36小时,36-48小时,>48小时.
- 进行了生存和子组分析.
主要成果:
- 与延迟>48小时相比,在48小时内进行手术并没有独立地与减少六年死亡率有关.
- 独立的死亡预测因素包括年龄较大,男性性别,高ASA/CCI得分,住院并发症和术后逗留时间较长.
- 胸腔间骨折的死亡风险高于腿部部骨折.
结论:
- 部骨折手术时间不是死亡率的独立预测指标.
- 手术延迟与死亡率相关,但可能是由于并发症选择而不是直接因果关系.
- 手术后住院和患者的并发病是显著的死亡因素.
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