UNASSIGNED: The clinical data of 1322 consecutive patients who underwent bipolar hemiarthroplasty for osteoporotic femoral neck fractures at a tertiary medical center were analyzed. Data from the patients\' electronic medical records, including demographic information, comorbidities, and operative details, were collected. The risk factors and mortality rates were analyzed.
UNASSIGNED: Within 90 days after surgery, 19.9% of patients returned to the ED. Surgery-related reasons accounted for 20.2% of the patient\'s returns. Older age, a high Charlson comorbidity index score, chronic kidney disease, and a history of cancer were identified as significant risk factors for unplanned ED visits. Patients with uncemented implants had a significantly greater risk of returning to the ED due to periprosthetic fractures than did those with cemented implants (P = 0.04). Patients who returned to the ED within 90 days had an almost fivefold greater 1-year mortality rate (15.2% vs 3.1%, P < 0.001) and a greater overall mortality rate (26.2% vs 10.5%, P < 0.001).
UNASSIGNED: This study highlights the importance of identifying risk factors for unplanned ED visits after bipolar hemiarthroplasty, which may contribute to a better prognosis. Consideration should be given to the use of cemented implants for hemiarthroplasty, as uncemented implants are associated with a greater risk of periprosthetic fractures.
■分析了在三级医疗中心接受双极人工股骨头置换术治疗骨质疏松性股骨颈骨折的1322例连续患者的临床资料。来自病人电子病历的数据,包括人口统计信息,合并症,和操作细节,被收集。分析危险因素和死亡率。
■手术后90天内,19.9%的患者返回ED。手术相关原因占患者退货的20.2%。年纪大了,Charlson合并症指数得分很高,慢性肾病,癌症病史被确定为计划外ED访视的重要危险因素.与非骨水泥植入物患者相比,非水泥植入物患者由于假体周围骨折而返回ED的风险明显更大(P=0.04)。在90天内恢复ED的患者的1年死亡率几乎高出五倍(15.2%vs3.1%,P<0.001)和更高的总死亡率(26.2%vs10.5%,P<0.001)。
这项研究强调了确定双极半髋关节置换术后计划外急诊就诊的危险因素的重要性,这可能有助于更好的预后。应考虑使用骨水泥植入物进行半髋关节置换术,因为非骨水泥植入物与假体周围骨折的风险更大。