Preoperative Risk Assessment Of Elderly Patients With Hip Fracture And Risk Prediction Equation Is Preliminary Established

Objective: Through study surgical risk factors of elderly patients with hipfracture, to evaluate surgical risk, and establish risk prediction equation ofelderly patients with hip fracture. Which use it forecast operation risk，andguide the clinical treatment in elderly patients with hip fracture，to lay thefoundation for further research on surgical risk of elderly patients with hipfracture.Method: By collected from January2004to December2013in our hospital546cases of surgical treatment of elderly hip fracture patients clinical data forretrospective study. The age、sex、preoperative examination data、preoperativecomplications、anesthesia、surgery way、in the case of operation and thecondition of the postoperative，etc data entry Epidata3.1software, and the useof software for logical error correction；This study used SPSS16.0software forstatistical analysis：First using χ2and t test methods for variable selection toremove meaningless, which is inspection standard for=0.05;The variableswas statistically significant when P<0.05. And rule out the interventionmeasures quality of the influence for the results，the discriminant analysis usingstepwise discriminant method after screening,which use the discriminant process of SPSS software to discriminate analysis. Through use its to getmeaningful variables and variation coefficient to establish the predictionequation. To the same set of data back to generation into the equation, next toanalyze the results.Results: Collection of surgical treatment of546cases of elderly patients withhip fracture, Man: cases of223, female: cases of323; At the beginning of theremaining518cases after screen, the original judgment of “1”108cases,410cases of the original judgment of “0”; Through the statistical analysis to getpreoperative surgical risk prediction equation is obtained:Y=0.042Xwbc+0.004Xbcr+0.515Xnyha+0.227Xmmse+0.594Xxxghb+1.513Xhxhb+1.189Xmnhb+2.703Xqqhb-2.138；The role of each variable in the above equation to the discriminant result sizecan use standardized coefficient estimation，and the standardization of thevariable coefficient, respectively：wbc（numeration of leukocyte unit x109/L）0.154，bcr (serum creatinine unit umol/L)0.222，nyha（cardiac functionalgrading）0.357，mmse（Mini Mental State Examination）0.171，xxghb（cardiovascular system complications）0.213，hxhb（Respiratory systemcomplications）0.553，mnhb（Urinary system complications）0.270，qqhb（Other tumor、consumptive disease, etc complications）0.419；Put back thecases into the equation, combined surgery preoperative risk decision accuracy：84.0%.Variable values relating to a sample of generation into the discriminantequation, the definition of the discriminant points Y>0as the risk level “1”, identifying points Y <0of the definition of risk level “0”. Identifying risk forlevel “0”of Center points is-0.413，Identifying risk for level“1”of Center pointsis1.568.Conclusion：(1) Surgical risk factors of elderly patients with hip fractureinfluence the result of the forecast，which Can be expressed in standardizedcoefficient，respiratory complications among them is the most important riskfactor，followed by cardiovascular complications.(2) Preoperative risk prediction equation of elderly patients with hip fracture:Y=0.042Xwbc+0.004Xbcr+0.515Xnyha+0.227Xmmse+0.594Xxxghb+1.513Xhxhb+1.189Xmnhb+2.703Xqqhb-2.138；Preoperative surgical risk prediction are done by discriminant equation，Putback the cases into the equation, combined surgery preoperative risk decisionaccuracy：84.0%. This equation can be used in surgical risk preliminaryjudgment of elderly patients with hip fracture.