Analysis Of The Correlation Between Admission Haemoglobin Levels And Postoperative Recent Mortality In Elderly Patients With Hip Fracture

ObjectiveTo analyze the correlation between admission haemoglobin levels and postoperative recent mortality in elderly patients with hip fracture.MethodsMethods Retrospective analysis was performed on elderly patients(?65 years old)with hip fracture who underwent surgical treatment in Guangdong Province Traditional Chinese Medical Hospital(The Second Affiliated Hospital of Guangzhou Traditional Chinese Medicine University)from January 2013 to December 2015.Which we obtained 356 cases data and 308 cases clinical following-up(male 94 cases,female 214 cases,average 80.20 + 6.39 years).Accurate records of the basic personal information,gender,age,fracture type,preoperative TCM syndrome type of admission,comorbidity,admission haemoglobin levels,ASA grade,surgical methods,anesthesia,intraoperative bleeding loss,operation time.We survived the patient by telephone or outpatient follow-up within 1 year.The factors influencing the survival status were analyzed by single factor analysis and chi-square test(including Fisher exact test,R X C contingency table chi-square test),P<0.05 as the test standard.Multivariate analysis of the independent variables into the two-category Logistic regression model showed that P<0.05 was statistically significant.ResultsThis study included 308 patients,including 94 cases of male(30.5%),214 cases were female(69.5%),mean age 80.20 + 6.39 years,269 cases survived(87.3%),39 cases of death(12.7%),2 patients died in-hospital(0.6%),death in patients with an average age of 82.90 + 6 years,survival of patients the average age of 79.81 + 6.35 years.Fracture type:femoral neck fracture in 137 cases(44.5%),femoral intertrochanteric fracture in 171 cases(55.5%).Preoperative TCM syndromes:liver and kidney deficiency syndrome,qi stagnation and blood stasis syndrome in 218 cases(70.8%),deficiency of Qi and blood of two of 72 cases(23.4%),18 cases of phlegm and blood stasis(5.8%).Complications:Complications ? 2 cases of 183 cases(59.4%),complications>2 cases of 125 cases(40.6%).Admission haemoglobin levels:114.62 + 17.64g/L.ASA grade:grade ??? 190 cases(61.7%),??? 118 cases(38.3%).Anesthesia:spinal anesthesia in 277 cases(89.9%),31 cases of general anesthesia(10.1%).Surgical methods:Artificial joint replacement in 141 cases(45.8%),intramedullary internal fixation in 115 cases(37.3%),extramedullary internal fixation and other fixed forms of 52 cases(16.9%).Intraoperative blood loss:the average bleeding during surgery 184.17 + 145.30ml.Surgery time:an average of 93.08 + 31.86 minutes.Univariate analysis showed that age,preoperative TCM syndromes,comorbidities,and admission of haemoglobin levels,ASA grade was a risk factor for death in the elderly after one year of hip fracture(P<0.05),Multivariate logistic regression model for multivariate analysis showed that admission of haemoglobin levels(P=0.043,OR=0.625,CI 0.396?0.985)and ASA grade(P=0.021,OR=0.424,CI 0.205?0.877)were independent risk factors for 1 year of death in elderly patients with hip fractures.ConclusionThere are several factors that affect the recent mortality rate of hip fractures in the elderly,The study showed that age,preoperative TCM syndrome,complication,admission of haemoglobin levels and ASA grade were the risk factors for postoperative death in elderly patients with hip fracture after 1 years.The admission of haemoglobin levels and ASA grade were independent risk factors for postoperative mortality.Clinicians should pay attention to preoperative evaluation and perioperative management of hip fracture in elderly patients,and improve the clinical efficacy of patients with the treatment of traditional Chinese Medicine.