Observation And Analysis Of The Correlation Between Operation Time And Prognosis Of Senile Hip Fracture

Objective:To determine the optimal time window for hip fracture surgery in the elderly before the increased risk of complications and the correlation between surgery time and prognosis based on the preoperative waiting time data of elderly patients with hip fracture in Yueyang Second People's Hospital.Methods:Collection on January 1,2013 to December 31,2017 in Yueyang Second People's Hospital treated 967 cases of elderly hip fracture patients' medical records,according to the hospital to undergo surgery the waiting time of patients divided into early surgical group(after the injury to 48 h)or less operation time,delay surgery group(after the injury to operating time in 48 h ~ 72 h),late surgery group(> 72 h after injury to surgery time).Collect three groups of patients with general clinical data and indicators related to the operation,postoperative 1 month hip function in patients with analysis and comparison,length of hospital stay,postoperative complications(including: pressure sores,DVT and pulmonary infection,myocardial infarction,incision abnormal)and postoperative 30 days,90 days,1 year of mortality,and the influence of1-year mortality postoperatively in patients with risk factors were analyzed.Results:There was no significant difference in preoperative general data between the three groups(P >,0.05).In terms of postoperative complications,a single group comparison showed that there was a statistically significant difference in the incidence of respiratory complications among the three groups(P < 0.05).There were statistically significant differences in the incidence of cardiovascular complicationsbetween the three groups(P < 0.05).The incidence of postoperative respiratory and cardiovascular complications was lower in the early group.The length of hospital stay in the early group was 5.04 days shorter than that in the late group(P < 0.05),and the length of hospital stay in the delayed group was 6.34 days shorter than that in the late group(P < 0.05).In terms of hip function at 1 month after surgery(Harris score),hip function at 1 month after surgery was significantly higher in the early group and the delayed group than in the late group(P < 0.05);In terms of postoperative mortality,the mortality rate of patients in the early group was 1.94%,which was significantly lower than that in the delayed group(9.94%)and the late group(9.66%)(P < 0.05).Multivariate regression analysis showed that the number of preoperative complications and the timing of surgery were the risk factors for 1-year postoperative mortality(P < 0.05).Conclusions:1.The results of this study showed that the waiting time before surgery was more than 48 hours,the risk of pulmonary infection and myocardial infarction was significantly increased,and the mortality rate was increased one year after surgery.The waiting time before surgery was more than 72 hours,and the hospitalization time was significantly increased.2.The operation time of hip fracture in the elderly is related to the prognosis,and early operation can reduce the complications and mortality.3.The more diseases the elderly patients with hip fracture had before surgery and the longer the waiting time before surgery,the greater the risk of death within 1 year after surgery.