背景:股骨骨折显著导致残疾,主要是老年人。尽管如此,关于股骨骨折术后肺炎的数据仍然很少.我们的研究旨在探讨术后肺炎的发生率和对此类手术后预后的影响。
方法:回顾性研究分析了2016年至2022年住院的股骨骨折患者。我们仔细检查了术后结果,包括肺炎,住院时间,重症监护病房(ICU)入院,和住院死亡率。我们建立了严格的术后肺炎诊断标准,结合临床体征和放射学证据,排除既往感染或术后24小时内出院的患者。统计分析包括卡方检验和t检验,线性回归,并使用SPSS进行逻辑回归。
结果:在636例患者中,10.8%被诊断为术后肺炎。平均年龄79.55±8.57岁,男性患病率为47.8%。常见的合并症是高血压(78.3%),糖尿病(60.9%),和心血管疾病(40.6%)。手术干预被归类为髓内钉(40.6%),部分髋关节置换术(37.7%),和动力髋螺钉(21.7%)。术后肺炎与年龄相关(AOR=1.053,95%CI1.020~1.087,p=0.002),ICU入院(AOR=2.283,95%CI1.256至4.148,p=0.007),住院时间较长(AOR=1.079,95%CI1.030~1.130,p=0.001)。在调整其他变量后,肺炎的存在与住院时间增加2.621天相关(p<0.001,95%CI:1.454至3.789)。
结论:本研究强调了股骨骨折患者术后肺炎的临床意义,发病率为10.8%。与年龄的显着关联,住院时间延长,观察到ICU入院,强调解决这一并发症以改善患者预后和医疗资源分配的必要性。
BACKGROUND: Femoral fractures significantly contribute to disability, predominantly in the elderly. Despite this, data on postoperative pneumonia following femoral fracture surgeries remains sparse. Our study sought to explore the incidence and impact of postoperative pneumonia on outcomes following such surgeries.
METHODS: A retrospective study analyzed femoral fracture patients hospitalized from 2016 to 2022. We scrutinized postoperative outcomes, including pneumonia, hospital stay duration, intensive care unit (ICU) admissions, and in-hospital mortality. We established stringent diagnostic criteria for postoperative pneumonia, incorporating both clinical signs and radiological evidence, excluding patients with prior infections or those discharged within 24 h post-surgery. Statistical analyses involved Chi-square and t-tests, linear regression, and logestic regression using SPSS.
RESULTS: Out of 636 patients, 10.8% were diagnosed with postoperative pneumonia. The average age was 79.55 ± 8.57 years, with a male prevalence of 47.8%. Common comorbidities were hypertension (78.3%), diabetes (60.9%), and cardiovascular diseases (40.6%). Surgical interventions were categorized as intramedullary nailing (40.6%), partial hip replacement (37.7%), and dynamic hip screw (21.7%). Postoperative pneumonia was associated with older age (AOR = 1.053, 95% CI 1.020 to 1.087, p = 0.002), ICU admission (AOR = 2.283, 95% CI 1.256 to 4.148, p = 0.007), and longer length of hospital stay (AOR = 1.079, 95% CI 1.030 to 1.130, p = 0.001). The presence of pneumonia was associated with a 2.621-day increase in hospitalization after adjusting for other variables (p < 0.001, 95% CI: 1.454 to 3.789).
CONCLUSIONS: This study accentuates the clinical significance of postoperative pneumonia in femoral fracture patients, with a noted incidence of 10.8%. A notable association with older age, prolonged hospital stays, and ICU admissions was observed, underscoring the necessity of addressing this complication to improve patient outcomes and healthcare resource allocation.