The influence of immediate surgical treatment of proximal femoral fractures on mortality and quality of life -: Operation within six hours of the fracture versus later than six hours
The influence of immediate surgical treatment of proximal femoral fractures on mortality and quality of life -: Operation within six hours of the fracture versus later than six hours
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DOI：
10.1302/0301-620x.85b8.14282
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发表时间：
2003-11-01
影响因子：
--
通讯作者：
Buchinger, W
中科院分区：
文献类型：
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作者：
Dorotka, R;Schoechtner, H;Buchinger, W
我们比较了182例股骨近端骨折患者立即和延迟手术治疗后的死亡率和结局。79例患者在骨折后6小时内接受手术（第1组），103例患者在此期间后接受手术（第2组）。在6个月随访时，第1组的死亡率明显较低。两组结局均良好，结局无差异。手术和麻醉因素似乎都没有影响死亡率。分组的细分显示，24小时内手术的患者比那些手术延迟的患者有更好的结局，尽管可能存在偏倚，因为患者没有被随机分配到立即或延迟手术治疗，数据表明，早期稳定可能与较低的死亡率相关。即使临床前延迟超过6小时，仍然应该尝试早期治疗，因为与我们的患者相比，24小时后似乎可以获得更好的结果。
We compared the mortality and outcome of 182 patients with proximal fractures of the femur after immediate and delayed surgical treatment. Seventy-nine patients were operated upon within six hours of the fracture (group 1) and 103 patients were operated upon after this period of time (group 2).At six months follow-up, group I had a significantly lower mortality rate. There was a good outcome in both groups with no differences in the outcome. Neither surgical nor anaesthetic factors appeared to have influenced mortality. The subdivision of groups revealed that patients operated on within 24 hours had a better outcome than those whose surgery was delayed.Although there may have been a bias, as patients were not randomly assigned to immediate or delayed surgical treatment, the data suggest that early stabilisation may be associated with a lower mortality rate. Even with pre-clinical delays of more than six hours early treatment should still be attempted, as better results seem to be achieved after 24 hours compared to a later time in our patients.