| ObjectiveCombined with the extensive popularization of the concept of the fast-track surgery(FTS)in recent years,the cumulated ambulation score of elderly patients with intertrochanteric fracture after 1,2 and 3 days operations were counted.To analyze the risk factors affecting the early hip function after intertrochanteric fracture surgery in the elderly,and to provide guidance for the elderly patients with intertrochanteric fracture to accelerate the rehabilitation after surgery.MethodsIn this study,52 patients with femoral intertrochanteric fracture treated by PFNA in the First Affiliated Hospital of Guangzhou University of TCM from June 1,2018 to January 31,2019 were enrolled in the prospective study.Age,sex,height,weight,underlying diseases,ejection fraction(EF),fracture type,operation time and CAS score were collected after admiss,ion(the sum of 3 consecutive days after operation).The perioperative blood loss was estimated by height,weight and hematocrit(the first day of admission and the third day after operation).Age,sex,height,weight,BMI index,heart disease,EF value,lung disease,hypertension,diabetes,fracture type,operation time,blood loss were considered as independent variables,CAS score as dependent variables.Statistical analysis method:the correlation between baseline data and CAS score was analyzed by Pearson correlation analysis,and the influencing factors with statistical significance and correlation were screened out.Multiple linear regression analysis was utilized to analyze the influencing factors of CAS score after PFNA internal fixation of femoral intertrochanteric bone in elderly patients,and the regression equation was calculated.Results1.Overall rehabilitation:A total of 52 elderly patients with intertrochanteric fracture of femur were included in the study,including 21 males(40%)and 31 females(60%)with an average age of 77±9.84:average height of 159±8.80 cm;average weight of 57±10.42 kg;average BMI of 22.7±4.23;10 patients with lung disease(19%)and 42 patients without lung disease(81%);12 patients with heart disease(23%)and no heart disease.Disease(77%);average EF value 70±7.85%;diabetes in 16 cases(30%)and diabetes in 36 cases(70%);hypertension in 16 cases(30%)and hypertension in 36 cases(70%);average blood loss 714±368.75 ml;Average operation time 98±45.09 min;unstable fracture in 24 cases(46%)and stable fracture in 28 cases(54%);CAS score 7.7±2.32.2.Influencing factors of early rehabilitation after operation:(1)Pearson correlation analysis was used to analyze the correlation between baseline data and CAS score:pulmonary disease was negatively correlated with CAS score,and the correlation degree was strongly correlated(r=0.628,P<0.01);cardiac disease was negatively correlated with CAS score,and the correlation degree was strongly correlated(r=0.554,P<0.01).Body weight was positively correlated with CAS,and the correlation degree was moderately correlated(r=0.370,P<0.01).Age was negatively correlated with CAS score and moderately correlated(r=0.346,P<0.05).BMI was positively correlated with CAS score and moderately correlated(r=0.312,P<0.05).Blood loss was negatively correlated with CAS score and moderately correlated(r=0.471,P<0.01).EF was positively correlated with CAS score and moderately correlated(r=0.394,P<0.01).There was not any significant correlation between height,sex,operation time,fracture type,hypertension,diabetes and CAS score(P>0.05).(2)By multiple linear regression analysis,the influence of blood loss(X9)on CAS score was negative,with coefficient value of-0.004(P<0.01);EF(X6)had positive effect on CAS score,with coefficient value of 0.068(P<0.01);lung disease(X4)had negative effect on CAS score,with coefficient value of-2.916(P<0.01);heart disease(X5)had negative effect on CAS score,with coefficient value of-1.867(P<0.01).There was no significant differences in CAS score among sex,age,BMI index,operation time,fracture type,diabetes mellitus and hypertension(P>0.05).The regression equation was Y=7.176-2.916X4-1.867X5+0.068X6-0.004X9.ConclusionThe influencing factors of early rehabilitation after PFNA internal fixation for femoral intertrochanteric fracture in the elderly include perioperative blood loss,EF value,lung disease and heart disease.Among them,perioperative blood loss,pulmonary disease and heart disease were negatively correlated with early recovery after operation.EF value was positively correlated with early recovery after operation.Targeted prevention,reduction of the occurrence of these risk factors contribute to the formulation of rehabilitation plans and the acceleration of post-operative rehabilitation. |
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