80岁以上股骨颈骨折，术后一年死亡，因为啥？

来源：304关节学术

Factors Predicting One-Year Mortality of Patients Over 80 Years Operated After Femoral Neck Fracture

80岁以上股骨颈骨折患者术后一年死亡率的预测因素

译者：罗殿中

Introduction: In the Spanish population, previous studies related to mortality after hip fracture are based on patients aged 60 to 102years and did not stratify patients according to the type of fracture. The objective of this study was to identify the factors with influence on mortality at one postoperative year in patients aged 80years or older after a femoral neck fracture.

简介：既往对西班牙人群髋部骨折后死亡率的研究集中在60至102岁的患者，并未根据骨折类型对患者进行分层。这项研究的目的是确定80岁以上股骨颈骨折患者术后一年死亡的预测因素。

Material and method: Retrospective study of cases and controls. Consecutive patients operated between 2015 and 2016 were included. Baseline characteristics, medical history and previous medication, analytical parameters, Charlson index, ASA scale, Barthel index and Pfeiffer questionnaire were studied. Surgical data and complications were recorded during follow-up. Survival was assessed by the Kaplan-Meier method and the variables that affected it by Cox regression.

材料和方法：本研究为回顾性病例对照研究。纳入了2015年至2016年间连续接受手术的患者。收集患者的信息包括：基线特征、病史和既往用药史、分析参数、Charlson指数、ASA量表、Barthel指数和Pfeiffer问卷。记录手术数据和随访期间并发症。通过Kaplan-Meier生存曲线评估生存率，并通过Cox回归分析明确影响生存率的变量。

Results: Mortality one year postoperatively was 21.1% and mean survival 10.3months (95%CI: 9.7-10.9). The Cox regression showed that age >87years, Barthel score ≤85 and the combination of anticoagulants with INR ≥1.5 were significant predictors of mortality during the first year of follow-up.

结果：术后一年的死亡率为21.1％，平均生存时间为10.3个月（95％CI：9.7-10.9）。Cox回归显示，年龄> 87岁，Barthel指数≤85和联合抗凝治疗的INR≥1.5是与术后一年死亡率的相关的重要指标。

Conclusion: The predictors of mortality during the first postoperative year after femoral neck fracture in octogenarian or older patients were: age>87years, physical dependence measured by a Barthel index score ≤85, and the use of anticoagulants with a INR ≥1.5 at admission.

结论：对于80岁以上或更高年龄的患者，股骨颈骨折术后第一年的死亡率预测因素为：年龄> 87岁，Barthel指数评分≤85，入院时抗凝的INR≥1.5。

文献出处：Novoa-Parra CD, Hurtado-Cerezo J, Morales-Rodríguez J, Sanjuan-Cerveró R, Rodrigo-Pérez JL, Lizaur-Utrilla A. Factors predicting one-year mortality of patients over 80 years operated after femoral neck fracture. Factores predictivos de la mortalidad al año en pacientes mayores de 80 años intervenidos de fractura del cuello femoral. Rev Esp Cir Ortop Traumatol. 2019;63(3):202-208. doi:10.1016/j.recot.2018.10.007