The Analysis Of Perioperative Risk Factors On Postoperative Complications And Death After Hip Fracture Surgery In Senile Patients

In recent years, the fast development of society and the acceleratedpopulation aging makes the hip fracture in senile patients become a seriouspublic health threat, as the high morbidity and mortality which may impactboth mental and life quality to the senile patients, and result as a medical andeconomic burden for both individual and public. Therefore, in order to avoidpostoperative adverse situation and improve the ling-term prognosis for thepatients, it is necessary to analyze the risk factors which may lead topostoperative complications or death after hip fracture surgery by investigatingthe relationship between preoperative risk factors and postoperativecomplications. In this paper, the possible correlation between the earlypreoperative risk factors and the postoperative complications or death after hipfracture surgery in senile patients was investigated by using retrospectiveanalysis, for determining the cause risk factors and providing a reference forhip fracture surgery of senile patients.Objective: To find out the risk factors which may lead to postoperativecomplications or death after hip fracture surgery in senile patients and discuss their inherent relationships.Method:265hip fracture surgery cases in The First Bethune Hospital ofJilin University from January2006to December2010with the patients over theage of65were studied by retrospective analysis. The gender, age, type offracture, preoperative medical complications, timing of the surgery, anesthesiamethod, surgical approach and intra-operative medical blood transfusion of thepatients were recorded accurately. Furthermore, the survival situations andpostoperative complications of the patients were recorded through telephonefollow-up, and the possible risk factors in the cases were divided intosubgroups according to clinical features. All data have been analyzed bylogistic regression analysis using SPSS17.0software.Results: Compared with the patients without preoperative complication, thepatients who got more than three kinds preoperative complications show asignificantly increase trend in incidence of postoperative complications withstatistically differences (P=0.000, OR=4.793). Meanwhile, the results indicatesthat both the patients with timing of surgery more than72hours afterinjury(P=0.001, OR=3.836) and the patients with more than three kindspreoperative complications(P=0.011， OR=7.752) show a dramatic rise inmortality with statistically differences. But other factors do not show visibleeffect on the postoperative complications and survival situation of the patients.Conclusion: Among the risk factors in this study, a relationship only can befound between the preoperative medical complications and the postoperative complications, while both the preoperative complications and the timing ofsurgery are risk factors which can lead to the death in senile patients. Base onabove, the senile patients with hip fracture should be treated with surgery assoon as possible to improve their prognosis by reducing the morbidity andmortality related to postoperative complications.