Clinical Characteristics Of 475 Elderly Patients With Fall Fracture Combined With Cerebrovascular Disease And Risk Factors Of Perioperative Heart Failure

Objective: To analyze the clinical characteristics and risk factors of perioperative heart failure in 475 elderly patients with fall fracture combined with ` cerebrovascular disease.Methods: Retrospective collection of data was performed on elderly patients with fall fracture combined with cerebrovascular disease admitted to our department from January 2018 to December 2019.Sex,age,type and course of cerebrovascular disease,functional disability,time,location and triggers for falls,fracture classification,other comorbidities,and perioperative complications were analyzed,as were risk factors of perioperative heart failure.Results: A total of 509 elderly patients with fracture and cerebrovascular disease were collected,of which 475 cases were caused by falls,accounting for 93.3% of all injurious factors.Of the 475 selected patients,the proportion of men and women was 1:2.0,the age range was 65-98 years,the average age was 78.3±7.5 years old,80-84 years old was the most(24.2%),and the age of 90 was the least(6.5%).The main type of cerebrovascular disease was ischemic cerebrovascular disease(72.8%).The incidence of fracture after 3-12 months and 1 year accounted for 34.1% and54.1% respectively.89.5%,34.9%,33.9% and 30.1% of the patients had ADL disorder,language disorder,swallowing disorder and cognitive disorder respectively.The fall time was concentrated in the daytime(70.1%),and the location was mainly indoor(57.5%).The main causes were unstable walking or limb weakness(36.8%).The main fracture sites were femoral intertrochanteric fracture and femoral neck fracture(43.8%,30.5%).Patients with other diseases accounted for 81.7%,and 74.9% were complicated with cardiovascular diseases.The incidence of perioperative complications was77.3%,including anemia(38.1%),lower extremity deep venous thrombosis(38.1%),low protein(37.3%),perioperative heart failure(30.5%),etc.Advanced age,combined with cardiovascular disease,admission hemoglobin<9g/dl,admission low protein,daily fluid intake difference ≥500ml and pain score ≥ 5 were independent risk factors of perioperative heart failure.Conclusions: Fall is the main cause of fracture in elderly patients with cerebrovascular diseases.We should pay attention to improve the home environment,develop good behavior habits,and prevent falls.Female,80-84 years old patients with cerebrovascular diseases are the key people to prevent fall fracture.Most patients with cerebrovascular diseases have different degrees of dysfunction before falling fracture,and cerebrovascular diseases are more likely to fall fracture after 3-12 months and 1 year of cerebrovascular disease onset.Perioperative heart failure is the result of a variety of factors.Correct evaluation after fracture,early intervention,nutritional support,volume management and pain management are the key to prevention.