The Perioperative Research Of Elderly Hip Fracture Patients

Objective: To analyze the perioperatively treatment material of aged patients'hip injuries, to explore the method of causing these patient to pass perioperatively time safely and to evaluate POSSUM and P-POSSUM scoring system in predicting the postoperative mortality and morbidity in these patients.Methods:253 cases of aged patients' hip operation(from October 2004 to December 2005) were analyzed retrospectively, whose ages greater than 40 years. To analyze morbus internus before operation, the operation processes, the complication , to evaluate it using POSSUM and P-POSSUM scoring system. The predicted postoperative mortality and morbidity of complication were compared with the observed values.Results: There were 86 males and 167 females in this group. The average age was 69.92士11.87. Morbus internus before operation mainly was CAD 45.85%, hypertension 21.74%, anemia 16.60%, diabetes 14.23%; The surgery time≤2 hours account for 86.96%, blood transfusion account for 80.24% below 600 ml; Altogether appeared each kind of complication 79 examples(29 males and 50 females ),whose average age was 72.76士10.41. The morbidity of complication was 31.23%, including the alimentary deficiency 11.07%, the lungs infects 5.14%, DVT 4.35%, the cardiac disease 3.56%. 2 patients in this group died because of the cardia failure after operation.The mortality rate was 0.79%. There were 79 patients in the group with complication and 174 in the group without complication. There was no statistically difference between the patients with complication predicted by POSSUM and the observed (82 VS 79)( P > 0.05). There was agreement between the observed death number and the predicted calculated by P-POSSUM(5vs2)(P>0.05), though POSSUM overpredicted the overall mortality (16vs2) (P<0.05).Conclusion: Aged patients with hip injuries and morbus internus could pass perioperatively time safely by preoperative therapy and post-op treatment; The morbidity of complication of hip Fracture was 31.23% and the mortality rate was 0.79%; Modified POSSUM scoring msystem may be appropriately used to predict the morbidity of complication and P-POSSUM to mortality in patients of hip Fracture.