RUI Yunfeng 1,2,3,4,5 , LU Panpan 1,2,3,4,5 , LI Yingjuan 2,5,6 , DAI Guangchun 1,2,3,4,5 , MA Binbin 1,2,3,4 , ZOU Jihong 2,5,6 , CHEN Hui 1,2,3,4,5 , WANG Chen 1,2,3,4,5
  • 1. Department of Orthopedic Trauma, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China;
  • 2. Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China;
  • 3. Trauma Center, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China;
  • 4. Orthopaedic Trauma Institute of Southeast University, Nanjing Jiangsu, 210009, P.R.China;
  • 5. School of Medicine, Southeast University, Nanjing Jiangsu, 210009, P.R.China;
  • 6. Department of Geriatrics, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P.R.China;
RUI Yunfeng, Email: ruiyunfeng@126.com
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Objective To analyze the risk factors for postoperative mortality of elder patients with intertrochanteric fractures.Methods Patients with intertrochanteric fractures who underwent proximal femoral interlocking intramedullary nail fixation between January 2014 and December 2015 were enrolled in the study. Among them, 135 patients who met the selection criteria were included in the study, and the clinical data were collected, including gender, age, time from admission to surgery, comorbidities, and preoperative hemoglobin, albumin, and total lymphocyte count (TLC), and nutritional status. Univariate analysis and Cox proportional hazards regression model were used to screen the risk factors for postoperative mortality.Results Twenty-seven patients (20.0%) died within 2 years after surgery, and 16 (11.9%) died within 1 year after surgery. Univariate analysis showed that age, coronary atherosclerotic heart disease, number of comorbidities, preoperative hemoglobin and albumin levels were the influencing factors of postoperative mortality in elder patients with intertrochanteric fractures treated with proximal femoral interlocking intramedullary nail fixation (P<0.05). Multivariate analysis showed that age (≥80 years), combined more than 2 medical diseases, and preoperative albumin (<35 g/L) were the independent risk factors for postoperative mortality (P<0.05).Conclusion To improve the clinical outcomes, perioperative risk should be comprehensively evaluated and perioperative management strengthened in the elder patients with intertrochanteric fractures, especially those with advanced age, more combined diseases, and low albumin, for the high postoperative mortality.

Citation: RUI Yunfeng, LU Panpan, LI Yingjuan, DAI Guangchun, MA Binbin, ZOU Jihong, CHEN Hui, WANG Chen. Risk factors analysis for postoperative mortality of elder patients with intertrochanteric fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(12): 1538-1542. doi: 10.7507/1002-1892.201906079 Copy

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