Mustafa Kavak, Salih Oğuz, Zübeyir Akkoyun, Ulukan İnan
{"title":"老年髋部骨折患者30天死亡率的预测因素","authors":"Mustafa Kavak, Salih Oğuz, Zübeyir Akkoyun, Ulukan İnan","doi":"10.5152/j.aott.2022.21407","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the predictive factors affecting the 30-day mortality in geriatric hip fractures, investigate the effect of the timing of surgery, and thus determine the optimum cut-off time in delaying the surgery.</p><p><strong>Methods: </strong>A total of 596 patients(205 men, 391 women; mean age = 78.3 years) were included in this retrospective study. All possible predictive factors encountered in the literature review, including age, sex, fracture type, comorbidities, American Society of Anesthesiologists (ASA) score, surgical delay time, anaesthesia type, surgery type, need for erythrocyte replacement, postoperative complications, and the need for postoperative intensive care were analyzed. The predictive factors that were found to be significant as a result of the univariate analysis were included in the multivariate logistic regression analysis.</p><p><strong>Results: </strong>The reason for surgery was an extracapsular fracture in 359 patients (60.2%) and an intracapsular fracture in 237 (39.8%). Arthroplasty was performed in 256 patients (43%), while proximal femoral nails were used in 251 (42.1%), dynamic hips screws in 68 (11.4%), and cannulated screws in 21 (3.5%). 523 (87.8%) of the patients had an ASA score of 1 or 2, and 73 (12.2%) had an ASA score of 3 or 4. General anaesthesia was performed on 35.2% of the patients, while regional anaesthesia was administered to 64.8%. Major complications developed in 42 patients (7%), while minor complications were observed in 143 (24%). The mean surgical delay time was 3.21 days (1-9 days). The ASA score (P <0.001, OR: 56.83, CI: 5.26-2.820), anesthesia type (P = 0.036, OR: 3.225, CI: 0.079-2.264), surgical delay time (P <0.001, OR: 2.006, CI: 1.02-0.372) and major complication (P = 0.002, OR: 6.41, CI: 0.661-3.053) were determined to be predictive factors of 30-day mortality.</p><p><strong>Conclusion: </strong>This study found the median surgical delay time as three days in surviving patients and five days in deceased ones. Thus, a 3-day surgical delay may be acceptable and sufficient for medical optimization and the consensus of the multidisciplinary team.</p><p><strong>Level of evidence: </strong>Level IV, Therapeutic Study.</p>","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/a4/aott-56-4-240.PMC9612673.pdf","citationCount":"2","resultStr":"{\"title\":\"Predictive factors associated with thirty-day mortality in geriatric patients with hip fractures.\",\"authors\":\"Mustafa Kavak, Salih Oğuz, Zübeyir Akkoyun, Ulukan İnan\",\"doi\":\"10.5152/j.aott.2022.21407\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to determine the predictive factors affecting the 30-day mortality in geriatric hip fractures, investigate the effect of the timing of surgery, and thus determine the optimum cut-off time in delaying the surgery.</p><p><strong>Methods: </strong>A total of 596 patients(205 men, 391 women; mean age = 78.3 years) were included in this retrospective study. All possible predictive factors encountered in the literature review, including age, sex, fracture type, comorbidities, American Society of Anesthesiologists (ASA) score, surgical delay time, anaesthesia type, surgery type, need for erythrocyte replacement, postoperative complications, and the need for postoperative intensive care were analyzed. The predictive factors that were found to be significant as a result of the univariate analysis were included in the multivariate logistic regression analysis.</p><p><strong>Results: </strong>The reason for surgery was an extracapsular fracture in 359 patients (60.2%) and an intracapsular fracture in 237 (39.8%). Arthroplasty was performed in 256 patients (43%), while proximal femoral nails were used in 251 (42.1%), dynamic hips screws in 68 (11.4%), and cannulated screws in 21 (3.5%). 523 (87.8%) of the patients had an ASA score of 1 or 2, and 73 (12.2%) had an ASA score of 3 or 4. General anaesthesia was performed on 35.2% of the patients, while regional anaesthesia was administered to 64.8%. Major complications developed in 42 patients (7%), while minor complications were observed in 143 (24%). The mean surgical delay time was 3.21 days (1-9 days). The ASA score (P <0.001, OR: 56.83, CI: 5.26-2.820), anesthesia type (P = 0.036, OR: 3.225, CI: 0.079-2.264), surgical delay time (P <0.001, OR: 2.006, CI: 1.02-0.372) and major complication (P = 0.002, OR: 6.41, CI: 0.661-3.053) were determined to be predictive factors of 30-day mortality.</p><p><strong>Conclusion: </strong>This study found the median surgical delay time as three days in surviving patients and five days in deceased ones. 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Predictive factors associated with thirty-day mortality in geriatric patients with hip fractures.
Objective: This study aimed to determine the predictive factors affecting the 30-day mortality in geriatric hip fractures, investigate the effect of the timing of surgery, and thus determine the optimum cut-off time in delaying the surgery.
Methods: A total of 596 patients(205 men, 391 women; mean age = 78.3 years) were included in this retrospective study. All possible predictive factors encountered in the literature review, including age, sex, fracture type, comorbidities, American Society of Anesthesiologists (ASA) score, surgical delay time, anaesthesia type, surgery type, need for erythrocyte replacement, postoperative complications, and the need for postoperative intensive care were analyzed. The predictive factors that were found to be significant as a result of the univariate analysis were included in the multivariate logistic regression analysis.
Results: The reason for surgery was an extracapsular fracture in 359 patients (60.2%) and an intracapsular fracture in 237 (39.8%). Arthroplasty was performed in 256 patients (43%), while proximal femoral nails were used in 251 (42.1%), dynamic hips screws in 68 (11.4%), and cannulated screws in 21 (3.5%). 523 (87.8%) of the patients had an ASA score of 1 or 2, and 73 (12.2%) had an ASA score of 3 or 4. General anaesthesia was performed on 35.2% of the patients, while regional anaesthesia was administered to 64.8%. Major complications developed in 42 patients (7%), while minor complications were observed in 143 (24%). The mean surgical delay time was 3.21 days (1-9 days). The ASA score (P <0.001, OR: 56.83, CI: 5.26-2.820), anesthesia type (P = 0.036, OR: 3.225, CI: 0.079-2.264), surgical delay time (P <0.001, OR: 2.006, CI: 1.02-0.372) and major complication (P = 0.002, OR: 6.41, CI: 0.661-3.053) were determined to be predictive factors of 30-day mortality.
Conclusion: This study found the median surgical delay time as three days in surviving patients and five days in deceased ones. Thus, a 3-day surgical delay may be acceptable and sufficient for medical optimization and the consensus of the multidisciplinary team.
期刊介绍：
Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English.
The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication.
The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.
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