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首页> 外文期刊>Acute and critical care. >Elixhauser comorbidity measures-based risk factors associated with 30-day mortality in elderly population after femur fracture surgery: a propensity scorematched retrospective case-control study
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Elixhauser comorbidity measures-based risk factors associated with 30-day mortality in elderly population after femur fracture surgery: a propensity scorematched retrospective case-control study

机译：股骨骨折手术后老年人口30天死亡率的基于elixhauser合并措施的危险因素：倾向于自测到的回顾性案例控制研究

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BACKGROUND:As the average life expectancy increases, anesthesiologists confront unique challenges in the perioperative care of elderly patients who have significant comorbidities. In this study, we evaluated Elixhauser comorbidity measures-based risk factors associated with 30day mortality in patients aged 66 years and older who underwent femur fracture surgery.METHODS:We used the Medical Information Mart for Intensive Care III which contains the medical records of patients admitted to the intensive care unit (ICU) at Beth Israel Deaconess Medical Center in the United States between 2001 and 2012 to identify patients admitted to the ICU after femur fracture surgery (n=209). Patients who died within 30 days of admission (case group, n=49) were propensity score-matched to patients who did not (control group, n=98). The variables for matching were age, sex, race, anemia (hemoglobin ≤10 g/dl), and malignancy. We attempted to explain mortality via nine independent factors: hypertension, uncomplicated diabetes, complicated diabetes, congestive heart failure (CHF), cardiac arrhythmias, chronic pulmonary disease, renal failure, neurological disorders other than paralysis, and peripheral vascular disease.RESULTS:Logistic regression identified three significant risk factors: CHF, arrhythmias, and neurological disorders other than paralysis. The odds ratio (OR) for the 30-day mortality of CHF was 4.99 (95% confidence interval [CI], 2.18 to 12.06). The equivalent ORs for cardiac arrhythmias and neurological disorders other than paralysis were 2.61 (95% CI, 1.14 to 6.21) and 2.40 (95% CI, 0.95 to 6.48), respectively.CONCLUSIONS:Identifying patients with these risk factors (CHF, arrhythmias, and neurological disorders other than paralysis) will assist clinicians with perioperative planning and provide caregivers with valuable information for decision-making.
机译：背景：随着平均寿命的预期寿命增加，麻醉师在具有重要合体性的老年患者的围手术期关注方面面临着独特的挑战。在这项研究中，我们评估了66岁及更老的患者的30天死亡率的基于elixhauser合并措施的危险因素。方法：我们使用了含有患者的医疗记录的医学信息MART，其中包含患者的病历在2001年至2012年期间，在美国贝特以色列的重症监护股（ICU），在美国，在2001年至2012年期间，鉴定股骨骨折手术（N = 209）后鉴定患者入院的患者。在入院30天内（案例组N = 49）的患者均为未（对照组，N = 98）的患者匹配倾向。匹配的变量是年龄，性别，种族，贫血（血红蛋白≤10g/ dl）和恶性肿瘤。我们试图通过九个独立因素解释死亡率：高血压，简单的糖尿病，复杂的糖尿病，充血性心力衰竭（CHF），心律失常，慢性肺病，肾衰竭，瘫痪以外的神经疾病，以及外周血管疾病。结果：Logistics回归确定了三种显着的风险因素：CHF，心律失常和瘫痪以外的神经障碍。 CHF的30天死亡率的差距（或）为4.99（95％置信区间[CI]，2.18至12.06）。相当于瘫痪以外的心律失常和神经障碍的神经障碍分别为2.61（95％CI，1.14至6.21）和2.40（95％CI，0.95至6.48）。结论：鉴定有这些风险因素的患者（CHF，心律失常，除瘫痪之外的神经障碍和神经系统疾病将有助于临床医生进行围手术期规划，并提供具有有价值的决策信息的护理人员。

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