The outcome of fractures in very elderly patients
The outcome of fractures in very elderly patients
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DOI：
10.1302/0301-620x.93b6.25596
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发表时间：
2011-06-01
影响因子：
--
通讯作者：
Court-Brown, C. M.
中科院分区：
文献类型：
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作者：
Clement, N. D.;Aitken, S. A.;Court-Brown, C. M.
我们比较了1310例80岁或以上急性骨折患者的病例组合和结局变量。将一组318例高龄患者（≥ 90岁）与一组992例老年患者（80 - 89岁）进行比较，所有患者均在2007年7月至2008年6月期间就诊于单一创伤科。高龄组仅占总人群的0.6%，但占所有骨折的4.1%和所有骨科创伤入院的9.3%。该组患者更可能需要住院治疗（比值比1.4），不太可能恢复独立生活（比值比3.1），住院时间明显更长（10天，p = 0.01），高龄组30天和120天未校正死亡率更高。与下肢非髋部骨折相关的120天死亡率与股骨近端骨折相同，两个年龄组手术延迟>48小时的死亡率显著增加（p = 0.04）。这表明，早期手术和动员老年髋部骨折患者的原则，应扩大到包括所有这些在这个脆弱的年龄组。
We compared case-mix and outcome variables in 1310 patients who sustained an acute fracture at the age of 80 years or over. A group of 318 very elderly patients (>= 90 years) was compared with a group of 992 elderly patients (80 to 89 years), all of whom presented to a single trauma unit between July 2007 and June 2008. The very elderly group represented only 0.6% of the overall population, but accounted for 4.1% of all fractures and 9.3% of all orthopaedic trauma admissions. Patients in this group were more likely to require hospital admission (odds ratio 1.4), less likely to return to independent living (odds ratio 3.1), and to have a significantly longer hospital stay (ten days, p = 0.01).The 30- and 120-day unadjusted mortality was greater in the very elderly group. The 120-day mortality associated with non-hip fractures of the lower limb was equal to that of proximal femoral fractures, and was significantly increased with a delay to surgery >48 hours for both age groups (p = 0.04). This suggests that the principle of early surgery and mobilisation of elderly patients with hip fractures should be extended to include all those in this vulnerable age group.