老年髋部骨折病人住院时间延长现状及影响因素分析

章宁; 张大学; 孙丽鑫; 张婉静; 车金燕; 阳世伟

doi:10.13898/j.cnki.issn.1000-2200.2024.09.025

老年髋部骨折病人住院时间延长现状及影响因素分析

Study on the status of prolonged length of stay in elderly patients with hip fractures and its influencing factors

摘要

摘要:
目的探讨老年髋部骨折病人住院时间延长(PLOS)现状，并分析其影响因素。
方法回顾性分析接受手术治疗的老年髋部骨折病人1 444例临床资料，根据住院时间将病人分为PLOS组395例(住院时间≥15 d)和正常组1 049例(住院时间 < 15 d)，分析PLOS影响因素。
结果 PLOS发生率为27.35%(395/1 444)。单因素分析显示，年龄、骨折至手术时间、高血压、冠心病、偏瘫、脑卒中、红细胞体积分布宽度、白蛋白、ASA分级、手术方式、手术持续时间和术后肺炎在2组病人间差异均有统计学意义(P < 0.05~P < 0.01)。多因素回归分析显示，较长的骨折至手术时间、高血压、ASA≥Ⅲ级、手术持续时间长、术后肺炎均为老年髋部骨折病人PLOS的独立危险因素(P < 0.05~P < 0.01)。
结论老年髋部骨折病人PLOS的发生率较高，医务人员需及早识别PLOS危险因素，采取早期干预措施，以减少PLOS发生。

Abstract:
Objective To investigate the current status of prolonged length of stay (PLOS) in elderly hip fracture patients and analyze its affecting factors.
Methods A total of 1 444 elderly patients with surgical treatment for hip fractures were retrospectively analyzed.Patients were divided into two groups based on the length of stay.The PLOS group comprised 395 cases (hospital stay ≥15 d), while the normal group comprised 1 049 cases (hospital stay < 15 d).Univariate analysis and multivariate regression analysis were used to study the factors influencing PLOS.
Results The incidence of PLOS was 27.35% (395/1 444).Univariate analysis showed that age, time from fracture to surgery, hypertension, coronary artery disease, hemiparesis, stroke, red blood cell volume distribution width, albumin, ASA classification, surgical method, duration of surgery, and postoperative pneumonia showed statistically significant differences between the two groups of patients (P < 0.05 to P < 0.01).Multiple regression analysis showed that longer time from fracture to surgery, hypertension, ASA ≥Ⅲ, long duration of surgery, and postoperative pneumonia were independent risk factors for PLOS in elderly hip fracture patients (P < 0.05 to P < 0.01).
Conclusions The incidence of PLOS is high in elderly hip fracture patients, and healthcare professionals need to identify factors affecting PLOS early and take early interventions to reduce the incidence of PLOS.

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