老年髋部骨折患者手术等待时间与预后关系的研究

A Study on the Relationship between Surgical Waiting Times and Prognosis in Elderly Patients with Hip Fractures

摘要: 目的：探讨老年髋部骨折患者手术等待时间与预后的关系。方法：回顾性收集100例老年髋部骨折手术患者的临床资料，根据手术等待时间分为≤48小时组(25例)和>48小时组(75例)。比较两组患者的一般资料、合并症、实验室指标及死亡结局，采用多因素Logistic回归分析手术等待时间与死亡风险的关系。结果：两组患者在性别、年龄、骨折侧别、高血压、冠心病、糖尿病、脑梗死、慢性支气管炎等基线资料方面差异均无统计学意义(P > 0.05)。实验室指标中，仅球蛋白水平在两组间存在显著差异(30.86 ± 5.75 vs 28.07 ± 4.28, P = 0.033)。死亡结局方面，≤48小时组死亡率为16% (4/25)，>48小时组死亡率为24% (18/75)，但差异无统计学意义(P = 0.577)。多因素Logistic回归分析显示，在校正年龄、冠心病、球蛋白、高血压、血尿素氮后，等待时间 > 48小时是死亡的独立危险因素(OR = 9.268, 95% CI: 1.484~92.129, P = 0.033)。结论：手术等待时间 > 48小时是老年髋部骨折患者死亡的独立危险因素，临床应尽可能缩短手术等待时间以改善患者预后。

Abstract: Objective: This paper aims to investigate the relationship between surgical waiting time and prognosis in elderly patients with hip fractures. Methods: Clinical data were retrospectively collected from 100 elderly patients who underwent surgery for hip fractures. Patients were divided into a group with a surgical waiting time of ≤48 hours (n = 25) and a group with a waiting time of >48 hours (n = 75). General characteristics, comorbidities, laboratory parameters, and mortality outcomes were compared between the two groups, and a multivariate logistic regression analysis was performed to assess the relationship between surgical waiting time and the risk of death. Results: There were no statistically significant differences between the two groups in baseline characteristics such as gender, age, fracture side, hypertension, coronary heart disease, diabetes, cerebral infarction, and chronic bronchitis (P > 0.05). Among laboratory parameters, only globulin levels showed a significant difference between the two groups (30.86 ± 5.75 vs. 28.07 ± 4.28, P = 0.033). Regarding mortality, the mortality rate was 16% (4/25) in the ≤48-hour group and 24% (18/75) in the >48-hour group; however, the difference was not statistically significant (P = 0.577). Multivariate logistic regression analysis showed that, after adjusting for age, coronary heart disease, globulin, hypertension, and blood urea nitrogen, a waiting time >48 hours was an independent risk factor for death (OR = 9.268, 95% CI: 1.484~92.129, P = 0.033). Conclusion: A surgical waiting time >48 hours is an independent risk factor for mortality in elderly patients with hip fractures. Clinicians should strive to minimize surgical waiting time to improve patient prognosis.