Factors Retrospective Study 502 Cases Of Elderly Patients After Orthopedic Surgery Complications Affected

Objectives:By studying the relationship between the occurrence of common postoperative complications and preoperative and operative condition and preoperative laboratory indicators of elderly orthopedic surgery patients, we are going to explore the factors that influence the occurrence of common postoperative complications on elderly orthopedic surgery patients.Methods:In this study, the medical records of502elderly patients aged80years and abover who received orthopedic treatment and surgical treatment in Wangjing Hospital of China Academy of Traditional Chinese Medicine during July1st2003and December31st2013were collected to an excel database.After escriptive statistics, Logistic regression analysis were played by SPSS17.0for the five postoperative complications of which incidence were more than10%,to filter factors related to the complications.Results:In this study the proportion of male and female patients was1:1.95. Patients aged80to84years old group accounted for65.94%of all the patients. The average length of stay was26.76±16.95days. Admissions to hospital within one day after pathogenesis accounted for42.63%. The cases whose operation was arranged on the4-7day after admission accounted for46.41%. Injury caused by accident accounted for83.07%. In types of diseases, patients with fractures accounted for85.06%. The most common lesion was the hip jiont, accounting for65.34%. Preoperative complications accounted for57.77%.The main types of surgery were joint replacement and intramedullary nail fixation, accounting33.47%and33.07%respectively. The cases of operative time between1to2hours accounted for56.97%. The cases with blood loss less than200ml during the surgery accounted for50.20%. Anesthesia with spinal anesthesia were the main anesthesia method which accounted for63.94%.A total of377patients suffered postoperative complications, the rate was75.10%, and6deaths made a mortality rate of1.20%. Incidence of postoperative complications ranging from high to low were anemia, hypoalbuminemia, lung infections, hypokalemia, hyponatremia, urinary tract infection, deep vein thrombosis, low chlorine levels, stress ulcers and respiratory failure. The usage rate of Chinese traditional medicine among all patients during hospitalization was80.28%.The logistic regression analysis showed that the main factors influencing on postoperative anemia in elderly orthopedic surgery patients were use of Chinese medicines, operative method and anesthesia ect.. The main factors influencing on the postoperative hypoproteinemia were preoperative serum calcium quantification,use of Chinese medicines and previous blood pressure ect. The main factors influencing on postoperative pulmonary infection were the history of chronic bronchitis, use of Chinese medicines and serum potassium ect. The main factors influencing on postoperative hypokalemia were gender, RBC and use of Chinese medicines ect. The main factors influencing on postoperative hyponatremia were serum calcium, the injured area and use of Chinese medicinesConclusion:1. The using of Chinese traditional medicine(TCM) may has a preventive effect on postoperative complications;2. Elderly patients undergoing orthopedic surgery were main female and the ones80-84years old; they were mainly caused by accidental injury; the main type of diseases was fractures with the major lesion in the hip joint (proximal femur);3. The history of chronic bronchitis may be a high risk factor for the occurrence of postoperative pulmonary infection;4. Blood calcium and albumin may be meaningful indicators to predict occurrence of postoperative complications;5. Operative method and anesthesia may have influence on the incidence of postoperative complications.