Quantitative analysis of operation risks for femoral intertrochanteric fractures under the guidance of Acute Physiology and Chronic Health Evaluation system
10.3760/cma.j.issn.1671-7600.2018.01.014
- VernacularTitle:急性生理学与慢性健康状况评价系统指导下股骨转子间骨折手术风险的量化分析
- Author:
Hua GAO
1
;
Baojun WANG
;
Liang ZHAO
;
Yadong LI
;
Zhenyu LIU
;
Xiaodong BAI
;
Wentao CHEN
;
Changgui LIU
Author Information
1. 首都医科大学附属北京友谊医院骨科
- Keywords:
Hip fractures;
Scoring system;
Mortality
- From:
Chinese Journal of Orthopaedic Trauma
2018;20(1):76-79
- CountryChina
- Language:Chinese
-
Abstract:
Objective To quantitatively analyze the operation risks for femoral intertrochanteric frac-tures under the guidance of Acute Physiology and Chronic Health EvaluationⅡ( APACHEⅡ) . Methods A retrospective analysis was performed among the 226 patients with femoral intertrochanteric fracture who had re-ceived surgery between January 2013 and January 2016. They were 59 men and 167 women, aged from 69 to 106 years ( average, 75. 4 ± 6. 1 years ) . Their average APACHEⅡscore was 18. 3 ± 6. 3 ( from 5 to 34 ) . They were divided into 3 groups according to their APACHEⅡscores: 127 cases in the low risk group (≤ 15 ) , 68 cases in the medium risk group ( from 16 to 24 ) and 31 cases in the high risk group ( ≥25 ) . The mortality was compared between the 3 groups. The deaths and survivals were compared in each group in terms of age, oper-ation time, intraoperative blood loss, postoperative blood transfusion and combined internal diseases. Results Thirteen patients died during hospitalization, giving a mortality of 5. 7％ ( 13/226 ) . The causes for death were heart attack in 6 cases, respiratory failure in 4, toxic shock in 2 and renal failure in one. The mortality in the high risk group ( 22. 6％, 7/31 ) was significantly higher than in the low risk group ( 1. 6％, 2/125 ) and in the medium risk group ( 5. 9％, 4/68 ) ( P <0. 05 ) . In the low risk group, the intraoperative blood loss was sta-tistically different between deaths and survivals ( P <0. 05 ); in the medium risk group, the intraoperative blood loss and postoperative blood transfusion volume were statistically different between deaths and survivals ( P <0. 05 ); in the high risk group, the age and intraoperative blood loss were statistically different between deaths and survivals ( P <0. 05 ) . Conclusions APACHEⅡcan be used to quantitatively evaluate the patients with femoral intertrochanteric fracture who usually suffer from intraoperative complications and concomitant in-ternal diseases. The most significant risk factor may be intraoperative blood loss.
