| Part 1: Intertrochanteric femoral fractures: an epidemiological analysis of 618 cases in XinjiangObjective: To study the epidemiological characteristics of the intertrochanteric femoral fractures of the inpatients,so as to provide a scientific basis for strategic study on the prevention and treatment of the intertrochanteric femoral fractures.Methods: Clinical data of 618 patients with intertrochanteric femoral fractures admitted in the First Affiliated Hospital of Xinjiang Medical University from January 2007 to December 2017 were analyzed retrospectively.The patient characteristics,injury time and causes,treatment methods,intraoperative indexes,hospitalization time,hospitalization costs and mortality at 6 months after treatment were collected for analyzing the epidemiological characteristics.SPSS 22.0 software was used for data analysis.Results:(1)There were significant differences in distribution of the intertrochanteric femoral fractures in terms of age and sex(P<0.05).The amount of patients aged ≥61 years old was most,accounting for 81.39%.The left side was more than right side(1.04:1).The proportion of male patients was more than female patients(1.01:1).(2)The number of patients increased with time increasing(P<0.05).Season distribution of injury showed significant difference(P<0.01),most injured in winner(44.5%).(3)The number of patients from Urumqi accounted for most,300 cases(48.54%).(4)There was significant difference in the distribution of injury cause(P<0.05),and slip was the leading cause(78.64%).Distribution of injury cause was significantly different at different ages and sexes(P<0.05).(5)There was no significant difference in time distribution from injure to surgery in patients with different ages(P>0.05).(6)Surgery was the predominant management approaches,accounting for 89.32%.At 6 months after surgery,the mortality rate of surgical treatment was significantly lower than that of conservative treatment(P<0.05).Conclusion: In summary,the distribution of the intertrochanteric femoral fractures of the inpatients has unique characteristics in aspects of age,sex,area distribution,injury causes,injury time,time from injury to surgery,treatment methods,and mortality at 6 months after treatment,which is worthy of further strategic study on prevention and treatment of the intertrochanteric femoral fractures.Part 2: Analysis of postoperative prognostic factors in elderly patients with intertrochanteric fracture of femurin XinjiangObjective: To discuss the main factors which influenced postoperative survival rate by retrospectively analyzing the postoperative clinical data of elderly patients with intertrochanteric fracture of femur in Xinjiang region.Methods: Clinical data of 131 patients who underwent surgical treatment in the first affiliated hospital of Xinjiang medical university from January 2013 to December 2017 were collected.Kaplan-meier method was used to figure out survival rate rates at 6 months,1 year,3 years and 5 years respectively,Single factor analysis,calculation of cumulative survival rate and drawing survival curve.and log-rank test was used in comparison among groups while COX proportional risk regression model was used for multi-factor analysis.Results: The overall survival rates at 6 months,1 year,3 years and 5 years were relatively [87.0%,95%CI(81.3%,92.7%)],[80.6%,95%CI(73.7%,87.5%)],[65.1%,95%CI(55.7%,74.5%)] and [52.1%,95%CI(37.4%,66.8%)].Univariate survival analysis showed that the age(2? =18.190,P=0.000),chronic comorbidities(?2 =36.142,P=0.000),Association with neurological disease(2? =4.093,P=0.043),Combination with renal insufficiency(2? =36.142,P=0.000),preoperative albumin level(?2 =3.872,P=0.049),ASA(American Society of Anesthesiologists)score(2? =7.369,P=0.025),Duration in ICU(2? =24.474,P=0.000)were the factors affecting the postoperative survival rate of elderly patients with intertrochanteric fractures.Multivariate survival analysis showed that chronic comorbidities(≥3)[HR=5.133,95%CI(2.690,9.790),P=0.000] and Duration in ICU(≥36h)[HR=9.229,95%CI(2.546,33.457),P=0.001]were independent risk factors for postoperative prognosis in elderly patients with intertrochanteric fractures.Conclusions: Factors which affect postoperative survival rate of elderly patients with intertrochanteric fracture of femur were various.Clinicians should strengthen the multidisciplinary collaboration and select appropriate treatment plans according to local medical conditions,combined with the specific conditions of patients,so as to improve the postoperative quality,the survival period and the prognosis of patients. |
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