The Research Of Scoring System About The Risk Of Elderly Hip Fracture Operation

At present, our countries elderly population is experiencing growth, as a result, the number of patients with hip fractures are increasing day after day. Currently, with the development of medical technology, both international and domestic scholars advocate operating on elderly hip fracture patients. However, since many of these elderly people often have various other internal and chronic conditions they have a higher risk of complications during the operation. Up to now there are many scoring systems to predict the complication rate and mortality among surgical patients. These scoring systems have their own pros and cons in real-world applications. The scope of application so far has been a bit more restrictive and the scoring systems don’t cover this special group of elderly patients who have hip fractures. Through researching medical records of elder patients with hip fracture surgery and screening out clinical indexes that have obvious influence on operation risk, by using these statistical methods we have established a specific scoring system for elderly patients with hip fracture(ORSEHF). To discuss the effectiveness of the ORSEHF scoring system in practical application we have made a comparison between ORSEHF and P-POSSUM.A retrospective analysis was made on clinical data of 263 cases of elder patients with hip fractures. We selected potential patients with possible risk factors related to post-operative complications and mortality as independent variables, to compare with numbers of incidence that actually happened after the operation as dependent variables. Methods SPSS16.0 software package was used for general statistical analysis and chi-square test.The high risk factors(P<0.05) was determined by analysisof single factor and binary or multi-factor logistic regression. Survival analysis: Kaplan-Meier curve was used to describe the rate of survivors;Log-rank test and Cox regression model was applied to find the influencing high risk factors related to postoperative mortality in elder patients with hip fracture. According to the result of regression analysis the incidence of postoperative complications and mortality, significant risk factors were brought into the rating system. Using the analytic hierarchy process comprehensive evaluation, the weight of risk factors for postoperative complications and mortality, according to the characteristics of the elderly patients with hip fracture, refer to the current surgical system widespread application of P-POSSUM scoring system to establish a specific scoring system(ORSEHF).With P- POSSUM scoring system and ORSEHF scoring system for263 patients, detection effectiveness and superiority through the single factor analysis of variance(ANOVA) we compared the two scoring systems used in ROC curve in elderly patients with hip fractures. As a result, the ORSEHF scoring system is more effective than the P- POSSUM scoring system to predict risk in elderly patients with hip fracture surgery.We have established a suitable assessment of elderly patients with hip fracture surgery risk scoring system(ORSEHF). ORSEHF scoring system to predict risk in elderly patients with hip fracture surgery is better than that of P- POSSUM scoring system.Due to the restricted numbers of the experimental research sample,further research with a larger base of research participants is needed to improve the accuracy of the sensitivity to the surgical risk prediction of ORSEHF scoring system.