髋部骨折病例特征及术后转归情况

doi:10.12183/j.scjpm.2022.1066

摘要/Abstract

摘要： 目的探究髋部骨折病例特征及术后转归情况。方法以2017年1月1日至2020年12月31日哈尔滨市某医院诊治的髋部骨折患者为研究对象,收集髋部骨折患者的基本信息及临床资料并进行出院后1年的随访跟踪调查。采用描述性分析方法对患者特征及术后1年病死情况进行分析,并采用单、多因素分析方法对术后1年病死影响因素进行分析。结果本研究共纳入2 342例髋部骨折患者资料进行分析,其中2017年485例（20.71%）,2018年582例（24.85%）,2019年628例（26.81%）,2020年647例（27.63%）,收治病例数呈逐年上升趋势。男女性别比例为1∶1.53;年龄33~90岁,其中以70~79岁年龄段占比最高（26.35%）;骨折类型以股骨颈骨折占比较高（48.96%）,其次为股骨转子间骨折（45.99%）,股骨头骨折占比最低（5.04%）;发病人数最多的季节为冬季（27.67%）。4年间不同年龄、治疗方法、辅助中药治疗患者分布差异有统计学意义（P<0.05或P<0.01）,4年间不同性别、骨折类型、内科合并症、发病季节患者分布差异无统计学意义（均P>0.05）。完成髋部骨折患者出院后1年随访共2 331例,1年病死率为2.66%（62/2 331）。多因素分析结果显示,年龄增长（OR=2.063）、非手术治疗（OR=1.730）、白蛋白水平<35 g/L（OR=2.048）及有内科合并症（OR=2.330）是髋部骨折患者出院后1年病死的危险因素。结论髋部骨折病例多见于女性、≥60岁人群,股骨颈骨折是常见类型,多在冬季发病,且不同特征的患者临床转归存在明显差异。

关键词: 髋部骨折, 流行病学, 转归, 影响因素

Abstract: Objective To explore the characteristics and postoperative outcomes of hip fractures. Methods Taking patients with hip fracture diagnosed and treated in a hospital in Harbin from January 1, 2017 to December 31, 2020 as the research objects, the basic information and clinical data of patients were collected, and a follow-up investigation was conducted for 1 year after discharge. Descriptive analysis method was used to analyze the characteristics of patients and the 1-year postoperative mortality, and univariate and multivariate analysis methods were used to analyze the influencing factors of postoperative 1-year mortality. Results A total of 2 342 patients with hip fractures were included in this study for analysis, including 485 （20.71%） in 2017, 582 （24.85%） in 2018, 628 （26.81%） in 2019, and 647 （27.63%） in 2020, the number of admitted cases was increasing year by year. The gender ratio of male to female was 1∶1.53; the age group was 33-90 years old, among which the age group of 70-79 years old accounted for the highest proportion （26.35%）; the main fracture type was femoral neck fracture （48.96%）, followed by femoral intertrochanteric fracture （45.99%）, the femoral head fracture accounted for the lowest proportion （5.04%）; the season with the largest incidence was winter （27.67%）. There were statistically significant differences in the distribution of patients with different ages, treatment methods, and adjuvant traditional Chinese medicine treatment within 4 years （P<0.05 or P<0.01）, but there were no significant differences in the distribution of patients with different genders, fracture types, medical complications, and seasons of onset within 4 years （all P>0.05）. A total of 2 331 patients with hip fracture were followed up for 1 year after discharge, and the 1-year mortality rate was 2.66% （62/2 331）. The results of multivariate analysis showed that age （OR=2.063）, non-surgical treatment （OR=1.730）, albumin level <35 g/L （OR=2.048）, and medical complications （OR=2.330） were the risk factors for 1-year death in patients with hip fracture after discharge. Conclusions Hip fractures are more common in women and people over 60 years old. Femoral neck fractures are a common type, and most of them occur in winter. The clinical outcomes of patients with different characteristics are significantly different.

Key words: Hip fracture, Epidemiology, Prognosis, Influencing factor

中图分类号:

R614

李佳鑫, 王树人, 单志涛, 王特哈斯. 髋部骨折病例特征及术后转归情况[J]. 华南预防医学, 2022, 48(9): 1066-1070.

LI Jia-xin, WANG Shu-ren, SHAN Zhi-tao, WANG Te-hasi. Characteristics and postoperative outcomes of hip fractures[J]. South China Journal of Preventive Medicine, 2022, 48(9): 1066-1070.

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