نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشگاه علوم پزشکی مشهد

2 دانشگاه علوم پزشکی بیرجند

چکیده

هدف: هدف از این مطالعه بررسی میزان اثرعوامل مختلف در پیش آگهی بیماران مسن با شکستگی ناحیه هیپ میباشد تا با پیش بینی دقیق تر از پیش آگهی ، انتخاب نوع درمان جراحی یا غیر جراحی برای پزشک و بیمار راحت تر شود.
روش اجرا و مواد مورد استفاده: این مطالعه اپیدمیولوژیک بر روی بیماران با سن بیشتر از ۶۵ سال که با تشخیص شکستگی ناحیه هیپ در طی یکسال مراجعه کرده اند انجام شد. متغیرهای مستقل شامل جنس، سن بیمار، بیماری های همزمان، زمان سپری شده از شکستگی تا جراحی و نوع بیهوشی و در مورد متغیرهای وابسته امتیاز بارتل، مرگ و میر بعد از عمل و نوع روش درمان ارزیابی شد
یافته‌ها: سن متوسط جمعیت مورد مطالعه (۱۶۳ نفر) ۷.۷ ±۷۸.۷- با بازه سنی ۹۷ـ۶۵ که شامل ۹۱زن (۵۵.۸٪) و ۷۲ مرد (۴۴.۲٪) بود. بیشترین تعداد بیماران ما در بازه سنی ۷۶ تا ۸۵ سال(٪۴۸)قرار داشت. تعداد مرگ و میر در بیمارانی که تحت عمل جراحی قرار نگرفته اند در ماه نخست پس از شکستگی، در شکستگی گردن فمور ۳نفر (٪۱۱.۵) و در شکستگی اینترتروکانتریک نیز ۳ نفر (٪۱۱.۵) بود و همچنین تعداد مرگ و میر در یازده ماه بعدی پیگیری، در شکستگی گردن فمور یک نفر (٪۳.۸) و در شکستگی اینترتروکانتریک ۳ نفر(٪۱۱.۵) بود.
نتیجه‌گیری: در این مطالعه سن بیماران یک فاکتور تعیین کننده مهم میزان مرگ و میر بوده ، به گونه ای که با افزایش سن میزان مورتالیتی نیز افزایش پیدا کرده است،ولی نوع جنسیت در افزایش مرگ و میر موثر نیست

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Evaluation of short-term and long-term outcomes related to mortality in hip fractures in people over 65 years of age

چکیده [English]

Objective: The aim of this study was to evaluate the effect of various factors on the prognosis of elderly patients with hip fractures to make it easier for physicians and patients to choose the type of surgical or non-surgical treatment with more accurate prognosis.
Methods and materials used: This epidemiological study was performed on patients older than 65 years who presented with a diagnosis of hip fracture within one year. Independent variables including sex, age of the patient, concomitant diseases, time elapsed from fracture to surgery and type of anesthesia were evaluated for Bartel score, postoperative mortality and type of treatment.
Results: The mean age of the study population (163 people) was 7.7 ± 78.7- with the age range of 65-97 which included 91 women (55.8%) and 72 men (44.2%). The highest number of our patients was in the age range of 76 to 85 years (48%). The number of deaths in patients who did not undergo surgery in the first month after the fracture was 3 (۱ 11.5) in femoral neck fractures and 3 (۵ 11.5) in intracentric fractures. In the next eleven months of follow-up, Mir had one patient (۸ 3.8) in femoral neck fractures and three patients (11.5 ٪) in intracentric fractures.
Conclusion: In this study, the age of patients was an important determinant of mortality, so that mortality has increased with age, but the type of gender is not effective in increasing mortality.

کلیدواژه‌ها [English]

  • Hip fractures
  • Femoral Neck Fractures
  • Intertrochanteric fractures
  • mortality
  1. Chie WC, Yang RS, Liu JP, Tsai KS. High incidence rate of hip fracture in Taiwan: estimated from a nationwide health insurance database. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2004;15(12):998-1002.
  2. Chirodian N, Arch B, Parker MJ. Sliding hip screw fixation of trochanteric hip fractures: outcome of 1024 procedures. Injury. 2005;36(6):793-800.
  3. Zelenka L, Alt J, Knížková I, Kunc P, Lukešová D. Epidemiologická studie vlivu pohlaví, věku, mobility a doby úrazu na zlomeniny proximálního femuru. ACHOT. 2018;85(1):40-5.
  4. Farahmand BY, Michaelsson K, Ahlbom A, Ljunghall S, Baron JA. Survival after hip fracture. Osteoporosis International. 2005;16(12):1583-90.
  5. Bliuc D, Center JR. Determinants of mortality risk following osteoporotic fractures. Current Opinion in Rheumatology. 2016;28(4):413-9.
  6. Smith T, Pelpola K, Ball M, Ong A, Myint PK. Pre-operative indicators for mortality following hip fracture surgery: a systematic review and meta-analysis. Age and ageing. 2014 Jun 3;43(4):464-71.
  7. Vestergaard P, Rejnmark L, Mosekilde L. Has mortality after a hip fracture increased?. Journal of the American Geriatrics Society. 2007;55(11):1720-6.

 

 

 

 

 

 

  1. Icks A, Haastert B, Wildner M, Becker C, Rapp K, Dragano N, Meyer G, Rosenbauer J. Hip fractures and area level socioeconomic conditions: a population-based study. BMC Public Health. 2009;9(1):1-8.
  2. Baumgaertner MR. The pertrochanteric external fixator reduced pain, hospital stay, and mechanical complications in comparison with the sliding hip screw. The Journal of bone and joint surgery. American volume. 2002;84(8):1488-.
  3. Kim SJ, Park HS, Lee DW. Outcome of nonoperative treatment for hip fractures in elderly patients: A systematic review of recent literature. Journal of Orthopaedic Surgery. 2020;28(2):2309499020936848.
  4. Cheung CL, Ang SB, Chadha M, Chow ES, Chung YS, Hew FL, Jaisamrarn U, Ng H, Takeuchi Y, Wu CH, Xia W. An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study. Osteoporosis and sarcopenia. 2018 Mar 1;4(1):16-21.
  5. Jamal Sepah Y, Umer M, Khan A, Ullah Khan Niazi A. Functional outcome, mortality and in-hospital complications of operative treatment in elderly patients with hip fractures in thedeveloping world. International orthopaedics. 2010;34(3):431-5.
  6. Marufu TC, Mannings A, Moppett IK. Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review. Injury. 2015;46(12):2325-34.
  7. MA Ren-shi GG-s, WANG Cheng-xue, ZHU Dong and ZHANG Xi-zheng. relationship between surgical time and postoperative complications in senile patients with hip fractures. Chinese Journal of Traumatology. 2010;13(3):167-72.
  8. Wu JG YJ, Tang JT. Treatment choice and perioperative treatment of hip fracture in senile patients. Chin J Bone Joint Inj. 2005;20(1):47-8.
  9. Goh EL, Lerner RG, Achten J, Parsons N, Griffin XL, Costa ML. Complications following hip fracture: Results from the World Hip Trauma Evaluation cohort study. Injury. 2020;51(6):1331-6.
  10. Adam P. Treatment of recent trochanteric fracture in adults. Orthopaedics & Traumatology: Surgery & Research. 2014 Feb 1;100(1):S75-83.
  11. Lorich DG, Geller DS, Nielson JH. Osteoporotic pertrochanteric hip fractures: management and current controversies. Instructional course lectures. 2004;53:441-54.
  12. Smektala R, Endres HG, Dasch B, Maier C, Trampisch HJ, Bonnaire F, et al. Theeffect of time-to-surgery on outcome in elderly patients with proximal femoral fractures. BMC musculoskeletal disorders. 2008;9:171.
  13. Ding Y RD, Xiao M. Early outcome observation postoperative and related influencing factors in senile patients with hip fracture. J Clin Ortho. 2008;11(5):406-9.
  14. Carpintero P, Caeiro JR, Carpintero R, Morales A, Silva S, Mesa M. Complications of hip fractures: A review. World journal of orthopedics. 2014 Sep 18;5(4):402.
  15. Jiang DM YY. Operative risk assessment and treatment choice for hip fracture in senile patients Chongqing Med. 2008;37(10):1021-5.
  16. Alirio JD, Gerhardinger L, Oliphant BW, Jenkins PC, Cain-Nielsen AH, Scott JW, Hemmila MR, Sangji NF. Factors associated with optimal patient outcomes after operative repair of isolated hip fractures in the elderly. Trauma surgery & acute care open. 2020 Dec 1;5(1):e000630.
  17. Tay E. Hip fractures in the elderly: operative versus nonoperative management. Singapore medical journal. 2016;57(4):178.
  18. Chlebeck JD, Birch CE, Blankstein M, Kristiansen T, Bartlett CS, Schottel PC. Nonoperative geriatric hip fracture treatment is associated with increased mortality: a matched cohort study. Journal of orthopaedic trauma. 2019;33(7):346-50.
  19. Wade DT, Collin C. The Barthel ADL Index: a standard measure of physical disability? International disability studies. 1988;10(2):64-7.
  20. Mayoral AP, Ibarz E, Gracia L, Mateo J, Herrera A. The use of Barthel index for the assessment of the functional recovery after osteoporotic hip fracture: One year follow-up. PloS one. 2019;14(2):e0212000.