In-hospital mortality does not increase in patients aged over 85 years after hip fracture surgery. A retrospective observational study in a Japanese tertiary hospital
In-hospital mortality does not increase in patients aged over 85 years after hip fracture surgery. A retrospective observational study in a Japanese tertiary hospital
复制标题
髋部骨折手术后 85 岁以上患者的院内死亡率不会增加。
作者：
Y. Fujita;K. Shimada;Tomohiko Sato;M. Akatsu;K. Nishikawa;A. Kanno;T. Aizawa
髋部骨折是老年人常见的严重骨科损伤，需要手术治疗。在这项回顾性队列研究中，我们检验了年龄是否是手术后住院死亡率的重要危险因素，并进一步分析了这些患者的死亡原因和模式。方法我们查询了我院2010年初至2016年8月底75岁以上髋部骨折手术住院患者的电子病历，日本本岛的一家三级医院。提取的数据包括患者ID、年龄、性别、骨折位置、ASA-PS评分、麻醉类型、麻醉和手术持续时间、术后住院天数以及出院时的结局（包括院内死亡）。提取的数据被分为两组，根据患者的年龄在手术时：老年组（年龄< 85岁）和高龄组（年龄≥ 85岁），我们比较了患者的特点和管理变量和出院处置两组之间。尽管高龄组患者出院回家的比例较小，但两组之间的全因住院死亡率也相似（高龄组和高龄组分别为1.9%和1.6%）。6例患者死于晚期癌症，5例患者死于肺炎导致的insuffictions.ConclusionsThe结果表明，年龄是不是一个临床显着的危险因素，住院死亡率。降低住院死亡率的可能性存在于识别有误吸风险的患者并防止其发生。
IntroductionHip fracture is a common and serious orthopedic injury among the geriatric population, necessitating surgical treatment. We tested whether age is a significant risk factor for in-hospital mortality after surgery in this retrospective cohort study and, further, analyzed causes and pattern of death in those patients.MethodsWe queried the electronic hospital records of in-patients aged over 75 years who had undergone hip fracture surgery from the start of 2010 to the end of August 2016 in our hospital, a tertiary hospital on the main island of Japan. The extracted data included patient ID, age, gender, location of fracture, ASA-PS scores, types of anesthesia, durations of anesthesia and surgery, days of hospital stay after surgery, and outcomes at hospital discharge including in-hospital death. The extracted data were divided into two groups based on the patient’s age at the time of surgery: the aged group (age of < 85) and the advanced age group (age of ≥ 85 years), and we compared patient characteristics and management variables and discharge disposition between the two groups.ResultsEight hundred four patient records were extracted (360 in the aged and 444 in the advanced age groups). Although a smaller proportion of patients in the advanced age group could be discharged home, all-cause in-hospital mortality was also similar between the two groups (1.9 and 1.6%, aged and advanced age groups, respectively). Six patients died from advanced cancer, and five patients died of pneumonia resulting from aspiration.ConclusionsThe results of this study suggest that age is not a clinically significant risk factor for in-hospital mortality. The possibility decreasing in-hospital mortality exists in identifying patients at risk of aspiration and preventing it.
影响因子：
120.7
作者：
Neuman, Mark D.;Rosenbaum, Paul R.;Ludwig, Justin M.;Zubizarreta, Jose R.;Silber, Jeffrey H.
通讯作者：
Silber, Jeffrey H.
影响因子：
120.7
作者：
Brauer, Carmen A;Coca-Perraillon, Marcelo;Cutler, David M;Rosen, Allison B
通讯作者：
Rosen, Allison B