The Discovery And Research Of The Evaluate Score System About The Risk Of Elderly Patients' Hip Fracture Operation

【Objective】 The elderly patients' hip fracture is a commonly and Multiple diseases,and it has a very high operation risk rate,our research going by lying on the basis of current document and reports about P-Possum system,combining the character of elderly patients' cases,keep the Operative Severity Score not be changed, choose various kinds of Physiological evaluate index to improve the P-Possum system,we will call it the New-P-Possum,and make it use in evaluating the risk of elderly patients' hip fracture of orthopaedics, use the New-P-Possum scoring system apply in predicting the mortality of elderly patients' hip fracture operation,and compare and research it with P-Possum system. Discovery the value of new score evaluate system.【Method】Combine the objective relative documents and reports about the p-possum that evaluate the Mortality after the operation,collect and put totally one hundred and sixty one cases which called hip fracture from the year two thousand and nine in January to two thousand and eleven in December in order,among in it,all the eighty two cases that implement Bipolar artificial Femoral head replacement operation and all the another seventy nine hundred cases that implement the fixation of gamma-nail.Calculate the totally actually mortality in all of the elderly patients' hip fracture,then calculate the actually mortality of Bipolar artificial Femoral head replacement operation and the fixation of gamma-nail,after that,use the p-possum scoring system calculate the predict mortality of the elderly patients' hip fracture at first.Analysis the cause of death in death cases and make up a new scoring system according the relationship between the death reason and Physiological Score or Operative Severity Score before operation and the character of orthopaedics,we will call it New-P-Possum scoring system and use this system calculate the predict mortality of the elderly patients' hip fracture cases, compare the actually mortality to the two system in predicting the mortality of elderly patients' hip fracture,discovery and discuss which one would be better in predicting in mortality accurately and pertinence, use the Statistical software SPSS17.0to statistical analysis with the date.【Results】1.Use the P-POSSUM and NEW-P-POSSUM score system to calculate the mortality rate of one hundred and sixty one elderly patient with hip fracture after operation, calculate the actually mortality rate is seven point four and five percent,predict mortality rate of P-POSSUM is five point five and nine percent,predict mortality rate of NEW-P-POSSUM is seven point four and five percent.2.Use the P-POSSUM and NEW-P-POSSUM score system to calculate the mortality rate of eighty two patients(four cases death) with femoral of neck of fracture hip replacement operation, calculate the actually mortality rate is four point eight and seven percent, predict mortality rate of P-POSSUM is three point six and five percent,predict mortality rate of NEW-P-POSSUM is eight point five three percent.3.Use the P-POSSUM and NEW-P-POSSUM to calculate the mortality rate of seventy nine patients (eight cases death)with Intertrochanteric fracture use Gamma nail fixation operation calculate the actually mortality rate is ten point one and two percent,predict mortality rate of P-POSSUM is six point three and two percent,predict mortality rate of NEW-P-POSSUM is six point three two percent.4.There are no statistical difference between the P-POSSUM and NEW-P-POSSUM in predict mortality rate and actually mortality rate,the two system also have no statistical difference,according by the Statistical software SPSS17.0to statistical analysis with the date.【Conclusion】1.We just begin to build a NEW-P-POSSUM score system which could fit operation character of elderly patients hip fracture and evaluate the risk of operation by look for relevant document and analysis the relationship between the relevant factors of death reason in death cases and Physiological Score or Operative Severity Score.2.The NEW-P-POSSUM score system could be more Pertinence in evaluating the risk of elderly patients hip fracture operation by such discovery and research,the system could be more accurately in enough samples,but our experiment samples is so little,we can not gain the conclusion that the two system have obviously statistical difference.