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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
杨波,杨晋才,臧传义,梁智林,赵小林,陈晓丽.老年髋部骨折患者术后新发心脏不良事件的危险因素[J].中华老年多器官疾病杂志,2020,19(7):515~519
老年髋部骨折患者术后新发心脏不良事件的危险因素
Risk factors for new cardiac adverse events in the elderly after hip fractureoperation
投稿时间:2019-09-09  
DOI:10.11915/j.issn.1671-5403.2020.07.122
中文关键词:  老年人;髋部骨折;心脏不良事件;危险因素
英文关键词:aged; hip fracture; adverse cardiac events; risk factors This work was supported by the Horizontal Project of National Key Research Development Plan of the Science and Technology Ministry
基金项目:科技部国家重点研发计划项目横向课题(2016YFC110100);北京老年医院“525”人才培养科研专项
作者单位E-mail
杨波 北京老年医院 骨一科,,北京 100095 xiaoli_0427@yeah.netrisk 
杨晋才 首都医科大学附属北京朝阳医院骨科,北京 100020 xiaoli_0427@yeah.netrisk 
臧传义 北京老年医院 骨一科,,北京 100095 xiaoli_0427@yeah.netrisk 
梁智林 北京老年医院 骨一科,,北京 100095 xiaoli_0427@yeah.netrisk 
赵小林 北京老年医院 骨一科,,北京 100095 xiaoli_0427@yeah.netrisk 
陈晓丽 北京老年医院 心血管内科,北京 100095 xiaoli_0427@yeah.netrisk 
摘要点击次数: 26
全文下载次数: 26
中文摘要:
      目的 研究老年髋部骨折患者术后住院期间新发心脏不良事件的危险因素。方法 回顾性分析2014年7月至2018年6月在北京老年医院骨科所有住院的≥65岁的髋部骨折患者,收集所有患者的基线资料、术前合并症、麻醉方式等,分析其术后新发心脏不良事件的临床特点及危险因素。采用SPSS 22.0软件进行数据处理。对单因素分析有统计学意义的指标进行多因素logistic回归分析。结果 共纳入418例患者,住院(13.2±6.8)d,年龄(76.7±9.2)岁,住院期间新发心脏不良事件56例(发生事件组),发生率为13.4%,其中因心脏事件死亡3例,死亡率0.72%。未发生心脏不良事件362例(未发生事件组)。2组患者异常心电图、左室射血分数≥50%、血红蛋白≥90g/L、血清白蛋白≥33g/L、B型脑钠肽前体≥450pg/ml、全身麻醉、术后电解质紊乱比例比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,心血管系统疾病史(OR=13.58,95%CI 10.12~21.39;P<0.01)、合并≥4种内科基础疾病(除心血管系统)(OR=5.28,95%CI 1.21~15.25;P<0.01)、美国麻醉医师协会(ASA) Ⅲ/Ⅳ级(OR=4.01,95%CI 3.24~10.34;P<0.01)、年龄≥70岁(OR=2.86,95%CI 1.05~7.55;P<0.05)、血清白蛋白<33g/L (OR=2.61,95%CI 1.23~5.51;P<0.01)、血红蛋白<90g/L(OR=1.81,95%CI 1.03~6.21;P<0.01)、术后电解质紊乱(OR=1.11,95%CI 1.02~2.34;P<0.01)是老年髋部骨折患者术后新发心脏不良事件独立危险因素。结论 老年髋部骨折术后发生心脏不良事件是多种因素共同作用的结果,对于既往有心血管系统疾病史的患者应给与特别关注。
英文摘要:
      Objective To study the risk factors for new cardiac adverse events during post-operative hospitalization in the elderly patients with hip fracture. Methods A retrospective analysis was conducted on the elderly patients over aged 65 years with hip fracture undergoing surgical treatment in Beijing Geriatric Hospital from July 2014 to June 2018. Their baseline data, preoperative complications and anesthetic modes were collected and analyzed for the clinical features and risk factors of new cardiac adverse events during hospitalization. The data were processed with SPSS statistics 22.0. Multivariate logistic regression analysis was used to analyze the statistically significant indices found by univariate logistic regress analysis. Results A total of 418 patients were enrolled in this study, and they are at a mean age of (76.7±9.2) years and had an average length of hospital stay of (13.2±6.8) d. There were 56 cases reporting new adverse cardiac events during hospitalization (13.4%, cardiac events group). Three patients died due to cardiac events, accounting for 0.72% (3/418). And the left 362 cases were assigned into the non-cardiac events group. Significant differences were seen in the ratios of patients with abnormal electrocardiogram, left ventricular ejection fraction ≥50%, hemoglobin ≥90g/L, albumin ≥33g/L, pro-B-type natriuretic peptide ≥450 pg/ml, general anesthesia and electrolyte disturbance after operation between the cardiac and non-cardiac events groups (P<0.05). Multivariate logistic analysis showed that the history of cardiovascular diseases (OR=13.58, 95%CI 10.12-21.39; P<0.01), combination of basic diseases of internal medicine (except cardiovascular system) >4 (OR=5.28,95%CI 1.21-15.25; P<0.01), ASA grade Ⅲ/Ⅳ(OR=4.01,95%CI 3.24-10.34; P<0.01), age >70 years(OR=2.86, 95%CI 1.05-7.55; P<0.05), serum albumin <33g/L (OR=2.61,95%CI 1.23-5.51; P<0.01), hemoglobin <90g/L (OR=1.81,95%CI 1.03-6.21; P<0.01), electrolyte disturbance (OR=1.11,95%CI:1.02-2.34; P<0.01) were independent risk factors for new cardiac adverse events in elderly patients after operation for hip fracture. Conclusion Cardiac adverse events after hip fracture surgery in the elderly are the result of multiple factors. Special attention should be paid to those with history of cardiovascular diseases.
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