65岁以上老年骨科患者手术风险因素评估

[目的]研究与老年骨科病人手术后不良结果相关的风险因素。[方法]对2002年1月-2004年10月期间住院的339例65岁以上老年病人进行回顾性分析，以潜在性手术风险因素作为变量，术后死亡及各种手术后并发症作为因变量。采用SPSS11．5进行统计分析。[结果]术后死亡率为3．5％，13．6％的住院病人术后出现1个以上的并发症。ASA评估Ⅲ级以上、心功能Ⅱ级以上、肾功能不全及神志状况的异常对术后死亡率有显著影响。心功能Ⅱ级以上、心律失常、ASA评估Ⅲ级以上、术前饮食状况的异常和手术级别增加了术后并发症的发生率。[结论]尽管老年骨科患者手术后大部分恢复顺利，但仍有一定程度的并发症（13．6％）和术后死亡率（3．5％）。术前ASA评估Ⅲ级以上、心功能Ⅱ级以上是影响术后结果的最主要因素。

Operative risk factors assessment for 65 years or elder orthopaedic patients

[Objective]To study those risk factors that are associated with adverse postoperative outcomes in old orthopaedic patients.[Method]In Xuanwu Hospital,medical records of 65 years or elder orthopaedic patients in-hospital from January 2002 to October 2004 were reviewed.Take the potential preoperative risk factors associated with adverse postoperative outcomes as variates ,postoperative adverse outcomes as dependent variates.Data were analyzed with SPSS for Windows 11.5.[Result]In the study,the postoperative mortality rate was 3.5%.13.6% of these patients developed one or more complications.American Society of Anesthesiologists (ASA) classification,abnormal cardiac function, abnormal renal function and weak condition of consciousness are the most important risk factors of postoperative mortality,abnormal cardiac function,arrhythmia,ASA classification,poor eating status and operative degree increase the incidence of postoperative complication.[Conclusion]The study demonstrates that there are good postoperative outcomes in most of geriatric orthopaedic patients.But in some degree,there exist the postoperative morbidity (13.6%) and mortality (3.5%).Among operative risk factors,preoperative general status and functional status much influence the postoperative outcomes.