老年髋部骨折患者术后2年内再发对侧髋部骨折的危险因素研究

目的:探讨老年髋部骨折患者术后2年内再发对侧髋部骨折的相关危险因素。方法:回顾性分析2015年5月至2018年4月期间北京积水潭医院创伤骨科采用手术治疗的1 962例老年髋部骨折患者资料。男573例，女1 389例；首次骨折时的年龄中位数为81（75，86）岁。根据术后2年内是否发生对侧髋部骨折分为两组：对侧髋部骨折组...

A study of risk factors for contralateral hip fracture within 2 years following primary hip fracture surgery in elderly patients

Objective To study the risk factors for contralateral hip fracture within 2 years after primary hip fracture surgery in elderly patients.Methods A retrospective study was conducted of the 1,962 elderly patients who had been surgically treated for hip fractures at Department of Orthopaedic Trauma,Beijing Jishuitan Hospital from May 2015 to April 2018.They were 573 males and 1,389 females;the median age of primary hip fracture was 81(75,86)years.They were divided into 2 groups according to whether a contralateral hip fracture occurred or not within 2 years after primary hip surgery:134 patients in the contralateral fracture group and 1,828 ones in the contralateral fracture-free group.The duration from primary hip fracture to secondary contralateral fracture was recorded.Theχ2 test and Mann-Whitney U test were used to compare between the 2 groups their gender,age,walking ability,laboratory indexes upon admission,concomitant internal diseases,Charlson comorbidity index(CCI),duration from admission to surgery,duration from admission to discharge and complications during follow-up.The risk factors for contralateral hip fracture within 2 years after primary hip surgery were determined by the Cox's proportional hazard regression model.Results In the elderly patients with hip fracture,the 2-year cumulative incidence of secondary contralateral hip fracture was 6.83%(134/1,962)and the median duration from primary surgery to secondary contralateral hip fracture was 365(189,611)d.The risk factors for contralateral hip fracture were female(RR=2.081,95%CI:1.351 to 3.207,P=0.001),concomitant peripheral vascular disease(RR=5.876,95%CI:2.922 to 11.818,P<0.001),concomitant chronic obstructive pulmonary disease(RR=3.750,95%CI:1.897 to 7.413,P<0.001),progressively higher CCI(RR=1.363,95%CI:1.223 to 1.519,P<0.001),complicated pneumonia(RR=3.606,95%CI:2.054 to 6.332,P<0.001),complicated urinary infection(RR=7.670,95%CI:4.441 to 13.248,P<0.001),and complicated deep venous thrombosis(DVT)(RR=7.389,95%CI:3.992 to 13.677,P<0.001).Conclusions The risk factors for contralateral hip fracture within 2 years after primary hip fracture surgery in elderly patients may be female,concomitant peripheral vascular disease and chronic obstructive pulmonary disease,progressively higher CCI,and complicated pneumonia,urinary infection and DVT.