Clinical characters and influencing factors of perioperative pneumonia in elderly patients with hip fractures aged ≥80 years at a tertiary hospital in Beijing City
10.3760/cma.j.cn112150-20250330-00257
- VernacularTitle:北京某医院≥80岁高龄髋部骨折患者围手术期肺炎的临床特征及相关因素分析
- Author:
Yu XU
1
;
Xiaoyan WANG
1
Author Information
1. 首都医科大学附属北京积水潭医院 呼吸与危重症医学科，北京100035
- Publication Type:Journal Article
- Keywords:
Hip Fracture;
Perioperative pneumonia;
Geriatric;
Influencing factors
- From:
Chinese Journal of Preventive Medicine
2025;59(6):916-924
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze and summarize the clinical characteristics of perioperative pneumonia (POP) in elderly patients with hip fractures and to explore the related factors of the occurrence of POP and severe pneumonia.Methods:A cross-sectional study was conducted. The research subjects were hip fracture patients aged 80 years and above who were hospitalized and underwent surgery in Beijing Jishuitan Hospital, Capital Medical University, from January 1, 2014, to December 31, 2022. The basic information and clinical data of the research subjects were collected through the hospital information system. A multivariate logistic regression model was used to analyze the influencing factors of the occurrence of POP and its progression to severe pneumonia.Results:A total of 1 326 elderly patients who underwent hip fracture surgery were included, with an age of [ M ( Q1, Q3)] of 88 (84, 93) years. About 681 patients (51.4%) developed POP, of which 114 patients progressed to severe pneumonia (16.7%). The results of multivariate logistic regression analysis showed that advanced age ( OR=1.056, 95% CI:1.027-1.086), male ( OR=1.416, 95% CI:1.141-1.758), smoking history ( OR=1.159, 95% CI:1.132-1.166), a longer interval between fracture occurrence and surgery ( OR=1.097, 95% CI:1.070-1.125), general anesthesia for surgery ( OR=1.152, 95% CI:1.112-1.175), a history of diabetes ( OR=1.751, 95% CI:1.234-1.983), and higher fasting blood glucose ( OR=1.164, 95% CI:1.061-1.276) were associated with a higher risk of POP ( OR=1.010, 95% CI:1.002-1.017). Patients with a higher proportion of peripheral blood lymphocytes ( OR=0.981, 95% CI:0.971-0.993) and higher albumin levels ( OR=0.966, 95% CI:0.947-0.985) had a lower risk of POP. Further analysis revealed that POP patients with a history of diabetes ( OR=2.316, 95% CI:1.385-2.870), a higher proportion of peripheral blood neutrophils ( OR=1.843, 95% CI:1.790-1.900), higher B-type natriuretic peptide ( OR=1.213, 95% CI:1.197-1.324), and higher procalcitonin ( OR=1.228, 95% CI:1.134-1.329) were more likely to progress to severe pneumonia. However, POP patients with a higher proportion of peripheral blood lymphocytes ( OR=0.806, 95% CI:0.750-0.866) and higher albumin levels ( OR=0.933, 95% CI:0.898-0.969) had a lower risk of progressing to severe pneumonia. Conclusion:The incidence of POP is relatively high in elderly patients with hip fractures aged ≥80 years in the hospital. Age, gender, smoking history, the interval between fracture occurrence and surgery, surgical method, creatinine level, history of diabetes, fasting blood glucose level, the proportion of peripheral blood lymphocytes, and albumin level are influencing factors for the occurrence of POP. History of diabetes, fasting blood glucose, the proportion of peripheral blood neutrophils, B-type natriuretic peptide, procalcitonin, the proportion of peripheral blood lymphocytes, and albumin level are influencing factors for POP patients to progress to severe pneumonia.
