不同年龄阶段四肢骨折患者住院天数的比较分析

Comparative Analysis of the Length of Hospital Stay for Patients with Limb Fractures in Different Age Groups

摘要: 目的：探讨不同年龄阶段四肢骨折患者住院天数的差异及其影响因素，为制定年龄导向的临床路径、优化医疗资源分配提供依据。方法：采用回顾性队列研究设计，收集2022年1月至2025年5月珠海市中西医结合医院骨科收治的80例四肢骨折患者临床资料。按WHO年龄标准分为儿童组(1~17岁，n = 26)、成年组(18~64岁，n = 32)与老年组(≥65岁，n = 22)。比较三组患者住院天数，采用Kruskal-Wallis H检验、Mann-Whitney U检验进行单因素分析，并运用多元线性回归分析影响住院天数的独立因素。结果：三组患者住院天数差异具有统计学意义(H = 25.73, P < 0.01)。儿童组住院天数最短[M = 7.00天，Q1~Q3：5.00~9.25]，成年组次之[M = 10.50天，Q1~Q3：8.00~13.00]，老年组最长[M = 14.00天，Q1~Q3：11.75~17.00]。多元线性回归分析显示，老年(B = 3.92, 95% CI: 2.31~5.53)、下肢骨折(B = 2.18, 95% CI: 0.95~3.41)、手术治疗(B = 1.96, 95% CI: 0.55~3.37)及并发症发生(B = 3.45, 95% CI: 1.70~5.20)是延长住院天数的独立危险因素(均P < 0.05)，模型调整R² = 0.42。结论：年龄是影响四肢骨折患者住院天数的重要因素，老年患者住院时间显著延长。临床应针对老年群体加强并发症预防，实施个体化康复方案，并建立多学科协作模式，以优化住院周期，提升医疗服务效率。

Abstract: Objective: To explore the differences in the length of hospital stay among patients with limb fractures of different age groups and their influencing factors, and to provide a basis for formulating age-oriented clinical pathways and optimizing the allocation of medical resources. Methods: A retrospective cohort study design was adopted to collect the clinical data of 80 patients with limb fractures admitted to the Department of Orthopedics of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to May 2025. According to the WHO age standard, they were divided into the children group (1~17 years old, n = 26), the adult group (18~64 years old, n = 32), and the elderly group (≥65 years old, n = 22). The length of hospital stay of the three groups of patients was compared. Univariate analysis was conducted using the Kruskal-Wallis H test and the Mann-Whitney U test, and multiple linear regression analysis was used to analyze the independent factors affecting the length of hospital stay. Result: The difference in the length of hospital stay among the three groups of patients was statistically significant (H = 25.73, P < 0.01). The length of hospital stay in the children group was the shortest [M = 7.00 days, Q1~Q3: 5.00~9.25], followed by the adult group [M = 10.50 days, Q1~Q3: 8.00~13.00], and the elderly group was the longest [M = 14.00 days, Q1~Q3: 11.75~17.00]. Multiple linear regression analysis shows that Old age (B = 3.92, 95% CI: 2.31~5.53), lower extremity fractures (B = 2.18, 95% CI: 0.95~3.41), surgical treatment (B = 1.96, 95% CI: 0.55~3.37), and the occurrence of complications (B = 3.45, 95% CI: 1.70~5.20) prolonged the length of hospital stay Independent risk factors of the number (all P < 0.05), model adjustment R² = 0.42. Conclusion: Age is an important factor affecting the length of hospital stay for patients with limb fractures, and the hospital stay of elderly patients is significantly prolonged. Clinically, efforts should be made to enhance the prevention of complications for the elderly population, implement individualized rehabilitation programs, and establish a multidisciplinary collaboration model to optimize the hospitalization period and improve the efficiency of medical services.