Elderly Hip Fracture Postoperative Cognitive Dysfunction In The Analysis Of Related Factors

Objective:Retrospective analysis of hip fracture in elderly postoperative cognitive dysfunction in patients with risk factors and found that its possible control methods and measures to improve its efficacy and provide a theoretical basis for surgical treatment.Methods:To summarize the orthopedic hospital in February 2005-2009 years in February for more than 60 years of age (including 60 years old) elderly patients with hip fracture surgery in cases of clinical data, the annual lead 60-90 years of age, an average of 75.07 years of age; male 29 cases (31.5%), female 63 cases (68.5%), of which 56 cases of femoral neck fractures (60.9%); 36 cases of intertrochanteric fractures (30.1%). Active treatment of preoperative complications, intraoperative choose combined spinal and epidural anesthesia, continuous epidural anesthesia or general anesthesia, surgical methods for the dynamic hip screw(DHS), femoral head replacement, total hip arthroplasty. Survey the medical records of patients with sex, age, fracture type, preoperative complications, surgical time, surgical methods, anesthesia, intraoperative transfusion, postoperative complications and other factors. These factors as independent variables, POCD occurrence or not as the dependent variable. First of single factor analysis of their use of x2 test or T test; to P<0.05 for the difference was significant. Finally, the single-factor analysis confirmed that there was significant difference between the independent variables into Logistic regression model for multivariate analysis. All data processed by the statistical software SPSS17.0 completed.Results:POCD16 cases occurred in 92 patients, the incidence of 17.4%, single-factor analysis showed that age, anesthesia, preoperative medical diseases combined with the occurrence of POCD were significant; and whether or not the occurrence of POCD between the two groups and sex, surgery way, fractures, surgical time, intraoperative and postoperative blood transfusion, postoperative whether anemia, electrolyte disturbance and other complications, no significant statistical difference. Logistic regression analysis showed that age, anesthesia and postoperative complications are the independent risk factors for postoperative mortality. Conclusion:The hip fracture in elderly postoperative cognitive dysfunction and age, anesthesia, preoperative medical diseases combined correlation. Aggressive treatment of preoperative complications, the choice of anesthesia can be appropriate to reduce the occurrence of POCD.