Risk factors of heart failure within 1 year after surgery in elderly patients with hip fracture
10.3760/cma.j.cn501098-20230529-00304
- VernacularTitle:老年髋部骨折患者术后1年内心力衰竭的相关危险因素分析
- Author:
Xiaowei WANG
1
;
Tiansheng SUN
;
Zhi LIU
;
Jianzheng ZHANG
;
Jianwen ZHAO
Author Information
1. 中国人民解放军总医院第七医学中心骨科，北京 100700
- Keywords:
Aged;
Hip fractures;
Heart failure;
Risk factors
- From:
Chinese Journal of Trauma
2023;39(10):913-918
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of heart failure within 1 year after surgery for hip fracture in the elderly.Methods:A retrospective cohort study was conducted to analyze the clinical data of 476 elderly patients with hip fracture admitted to No.7 Medical Center, Chinese PLA General Hospital from January 2018 to December 2019, including 171 males and 305 females, at age of 60-104 years [(82.5±8.1)years]. There were 271 patients with intertrochanteric fractures and 205 with femoral neck fractures. The patients were divided into heart failure group ( n=111) and non-heart failure group ( n=365) based on the presence of heart failure within 1 year after surgery. The following items were recorded: gender, age, fracture type (intertrochanteric fractures and femoral neck fractures), comorbidities [hypertension, coronary heart disease, arrhythmia, pulmonary infection, chronic obstructive pulmonary disease (COPD), renal insufficiency and diabetes], use of anticoagulants before injury, walking ability and self-care ability before injury, hematological indicators (white blood cell count, hemoglobin, albumin), time from injury to surgery, types of anesthesia (general anesthesia and regional anesthesia), types of surgery (intramedullary nails, dynamic hip screws, cannulated screw and arthroplasty), blood transfusion, length of hospital stay, sorts of perioperative complications (cerebrovascular disease, delirium, pulmonary infection, acute myocardial infarction, malignant arrhythmia, urinary tract infection, venous thromboembolism, acute cholecystitis and intestinal obstruction), and number of perioperative complications. Univariate analysis was used to evaluate the relationship between the above indicators and heart failure within 1 year after surgery in the elderly patients with hip fracture. Multiple Logistic stepwise regression analysis was used to determine the independent risk factors for the heart failure. Results:Univariate analysis showed that age, coronary heart disease, arrhythmia, use of anticoagulants before injury, albumin, blood transfusion, length of hospital stay, and number of perioperative complications≥2 were correlated with heart failure within 1 year after surgery in elderly patients with hip fracture ( P<0.05 or 0.01). Multivariate Logistic stepwise regression analysis showed that coronary heart disease ( OR=1.50, 95% CI 1.10, 2.51, P<0.05), blood transfusion≥2 U ( OR=2.01, 95% CI 1.23, 3.29, P<0.01) and number of perioperative complications≥2 ( OR=2.12, 95% CI 1.27, 3.53, P<0.01) were significantly associated with heart failure within 1 year after surgery in elderly patients with hip fracture. Conclusion:Complications of coronary heart disease, blood transfusion≥2 U and number of perioperative complications≥2 are independent risk factors for heart failure within 1 year after surgery in elderly patients with hip fracture.
