| Research background and purpose:As for the research on surgical waiting time and postoperative complications,most scholars focus on hip fracture,including femoral neck fracture and intertrochanteric fracture.Different surgical methods of the two have a great impact on the correlation between surgical waiting time and postoperative complications.Therefore,it is necessary to narrow the scope of research objects and only conduct relevant studies on elderly patients with femoral neck fracture.When exploring the timing of fracture surgery,most scholars directly defined the operation group within 24 hours or 48 hours as the early operation group,while the purpose of this study was to define the early operation group and the delayed operation group by the cut-off point of the operation waiting time when the risk of complications after fracture of femoral neck in the elderly increased.The waiting time for surgery has an important effect on the risk of postoperative complications.The longer the waiting time for surgery,the higher the risk of postoperative complications.However,few scholars have discussed the influencing factors of delayed waiting time for surgery.Therefore,this study aims to clarify the factors affecting the waiting time for surgery,so as to provide reference for shortening the waiting time for surgery,reducing the risk of postoperative complications,and establishing the green channel for the treatment of femoral neck fracture in the elderly.Materials and Methods:Patients with femoral neck fracture who were over 65 years old and underwent hip replacement in the First Affiliated Hospital of Chengdu Medical College from January2016 to December 2020 were collected.According to the inclusion and exclusion criteria,223 patients’ medical records were collected.General information(gender,age,etc.),preoperative blood routine,preoperative disease complications and consultation times,waiting time for surgery,postoperative anemia(hemoglobin ≤90g/L),hypoproteinemia(albumin ≤3.5g/L),venous embolism of lower extremity,and pulmonary infection of patients were collected.RStudio software was used to analyze the correlation between surgical waiting time and postoperative anemia(hemoglobin ≤90g/L),hypoproteinemia(albumin ≤3.5g/L),venous embolism of lower extremity,andpulmonary infection,and to explore the optimal operating time point when the risk of these four postoperative complications increased.The optimal time point of operation was defined as the early operation group,and the reverse was defined as the delayed operation group.SPSS26.0 software was used to conduct a univariate analysis to explore whether the general information of patients,such as gender and age,preoperative blood routine,preoperative disease complications,and the number of consultations were influencing factors for the prolongation of surgical waiting time.Finally,factors with statistical difference were selected for multivariate Logistic regression analysis.Result:1.RStudio software was used to show that the surgical waiting time was correlated with postoperative anemia(hemoglobin≤90g/L),hypoproteinemia(albumin≤3.5g/L),pulmonary infection,and venous thrombosis of lower limbs(P correlation =)through restrictive cubic spline diagram.When the risk ratio of postoperative anemia(hemoglobin≤90g/L),hypoproteinemia(albumin≤3.5g/L),pulmonary infection and lower limb venous thrombosis was equal to 1,the waiting time for surgery was 4.015 days.2.According to the optimal operation time point(4.015 days),the operation waiting time ≤4 days was defined as the early operation group,and > 4 days was defined as the delayed operation group.There were 132 patients in the early operation group,including49 males(37.12%)and 83 females(62.88%),with an average age of 77.97±7.33 years.There were 91 patients in the delayed operation group,including 26 males(28.57%)and65 females(71.43%),with an average age of 78.32±6.93 years old.There were107(81.06%)and 25(18.94%)patients in the early operation group,and 74(81.32%)and17(18,68%)patients in the delayed operation group.There were 82(62.12%)patients with left femoral neck fracture and 50(37.88%)patients with right femoral neck fracture in the early operation group,and 45(49.45%)patients with left femoral neck fracture and46(50.55%)patients with right femoral neck fracture in the delayed operation group.3.There were no significant differences in basic information,preoperative blood routine,preoperative pulmonary disease,psychiatric disease,and lower limb venous embolism of patients(P > 0.05).There were statistical differences in preoperative hypertension,heart disease,diabetes mellitus,number of complications ≥3 cases,the number of preoperative consultation(P < 0.05).4.The results of multivariate Logistic regression analysis indicated that the number of preoperative consultation,combined with hypertension and heart disease were the factors affecting the length of operation waiting time,and the difference between groups was statistically significant(P < 0.05).Conclusion1.The risk of postoperative anemia(hemoglobin ≤90g/L),hypoproteinemia(albumin ≤3.5g/L),lung infection,and lower limb venous thrombosis will increase in elderly patients with femoral neck fracture whose waiting time for surgery is longer than 4 days.Patients should improve relevant examinations as soon as possible after hospitalization,make relevant preoperative preparations,and reduce the waiting time for surgery.2.Elderly patients with femoral neck fracture suffer from hypertension and heart diseases before surgery,and these underlying diseases combined before surgery may lead to an increase in the number of consultations,thus increasing the waiting time for surgery and increasing the risk of postoperative complications.When patients are admitted,multidisciplinary collaborative diagnosis and treatment can be adopted to reduce the number of consultations and evaluate the risk of preoperative complications as soon as possible,so as to achieve early surgery. |
PDF Full Text Request