Analysis Of Mortality Factors During Hospitalization And Within 1 Year After Intertrochanteric Fracture In Southern Liao Ning Province

Objective The risk factors of death during postoperative hospitalization and within 1 year in elderly patients with intertrochanteric fracture of femur were analyzed to provide reference guidance for reducing postoperative mortality.Method In this study,a total of 412 patients(aged ≥65years)with intertrochanteric fracture of femur admitted to and operated on from 2020 to 2021(two years)in three Grade-III hospitals including The First Affiliated Hospital of Dalian Medical University,the Second Affiliated Hospital of Dalian Medical University,Dalian Central Hospital were retrospectively analyzed.Information was collected through telephone follow-up,outpatient follow-up and other methods,and a total of 300 cases were followed up within 1 year.The basic data of patients,such as age,gender,admitted hemoglobin and albumin,pre-injury activity level,fracture complications,underlying diseases,injury to operation time,postoperative functional exercise level and other information were collected and collated.The death toll of patients during hospitalization and within 1 year was counted,and the collected information was divided into groups and assigned to count data.After univariate Chi-square test analysis,P<0.05 indicated statistical difference.Finally,factors with significant difference confirmed by univariate analysis were substituted into Logistic binary regression model to find independent risk factors of one-year mortality and explore the factors affecting death.Results A total of 412 cases were collected,of which 300 patients were effectively followed up.Among the 3 0 0 elderly patients with intertrochanteric fracture,1 2 died during hospitalization,the shortest hospitalization was 4 days,the longest hospitalization was 24 days,the average hospitalization date was 8.5 days,and 64 died within 1 year.The causes of death in all patients were as follows: lung infection,heart,brain,blood vessels,digestive tract diseases,multiple organ failure,etc.The results showed that the proportion of death caused by various causes was different.Among them,pulmonary infection was the main complication of intertrochanteric fracture in the elderly,accounting for 45.31% of the total 29 cases.Cardiovascular and cerebrovascular diseases followed,accounting for 22 cases,34.37%;Digestive tract disease(9 cases,14.06%);Other diseases,a total of 4 cases,accounting for 6.25%.General data of 300 patients were collected and counted by telephone follow-up,outpatient visit and other methods.Each factor was assigned and Chi-square test was performed.The test analysis showed that: Age,ADL score,admission hemoglobin,diabetes mellitus,duration from injury to hospital stay,duration from hospital stay to operation,fracture complications,postoperative functional exercise level and other factors had statistical significance on mortality during hospitalization and within 1 year(P<0.05).Gender,admitted albumin level,whether suffering from hypertension,whether suffering from pulmonary inflammation and fracture stability had no statistical significance on mortality.Then,Logistic binary regression analysis was performed on the above statistically significant factors,and the results showed: Age(OR= 1.073,P=0.002),in-hospital hemoglobin level(OR=0.951,P < 0.001),injury-to-hospital stay(OR= 1.207,P=0.038),and postoperative functional exercise level(OR=0.229,P=0.002)were independent risk factors for 1-year death in elderly patients with Intertrochanteric fracture of femur risk factor.Conclusion(1)The risk factors of death during hospitalization and within 1 year in elderly patients with intertrochanteric fracture of femur were basically the same: age,pre-injury,ADL score,admission hemoglobin level,diabetes mellitus or not,duration from injury to hospitalization,duration from hospitalization to surgery,fracture complications and postoperative functional exercise level were statistically significant risk factors for mortality.(2)Age,admission hemoglobin,length of stay from injury to hospitalization,and postoperative functional exercise level were independent risk factors for 1-year mortality in patients with intertrochanteric fracture of femur.(3)The mortality of elderly patients with intertrochanteric fracture of femur is the result of multiple factors.In order to reduce the mortality rate of patients,this study suggests strengthening elderly care,strengthening daily exercise,actively controlling diabetes and other basic diseases,ensuring nutrition intake,and actively preventing anemia.Strengthen health education and popularization of intertrochanteric fracture of femur,and seek medical attention as soon as possible in case of hip trauma;After fracture treatment,patients should also actively cooperate with doctors for functional exercises.