Objective: To analyze the risk factors for postoperative mortality of the elderly patients with femoral neck fracture undergoing hemiarthroplasty.
Methods: Patients who underwent hemiarthroplasty for femoral neck fractures between January 2011 and December 2015 were enrolled as object. One hundred and nine 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 level and nutritional status. Univariate analysis and Cox proportional hazard regression model were used to screen the risk factors for postoperative mortality.
Results: The 1-year and 2-year mortalities were 6.4% (7/109) and 17.4% (19/109), respectively. Univariate analysis showed that the age, preoperative hemoglobin level and nutritional status were the influencing factors of postoperative mortality in the elderly patients with femoral neck fractures treated with hemiarthroplasty ( P<0.05). Multivariate analysis showed that the age≥80 years and malnutrition were the independent risk factors for postoperative mortality ( P<0.05).
Conclusion: To improve the clinical outcomes, perioperative risk should be comprehensively evaluated by multidisciplinary and perioperative management should be strengthened in the elderly patients with femoral neck fracture, especially those with advanced age and malnutrition, for the high postoperative mortality.
目的: 分析老年股骨颈骨折患者人工股骨头置换术后死亡率及其危险因素。.
方法: 以 2011 年 1 月—2015 年 12 月因股骨颈骨折行人工股骨头置换术患者为研究对象，将符合选择标准的 109 例患者纳入研究，收集临床资料，包括年龄、性别、合并基础疾病数量、入院至手术时间以及术前血红蛋白、营养状况。采用单因素分析和 Cox 比例风险回归模型筛查术后死亡危险因素。.
结果: 术后 1 年和 2 年死亡率分别为 6.4%（7/109）和 17.4%（19/109）。单因素分析显示年龄、术前血红蛋白水平和营养状况是患者术后死亡的影响因素（ P<0.05）。多因素分析显示，年龄≥80 岁和营养不良是患者术后死亡的独立危险因素（ P<0.05）。.
结论: 老年股骨颈骨折患者人工股骨头置换术后死亡率高，对于此类患者，尤其是高龄和营养不良者，应多学科综合评估围术期风险，加强围手术期管理和优化，以改善临床预后。.
Keywords: Femoral neck fracture; hemiarthroplasty; mortality rate; risk factor; the elderly.