Multivariate Analysis Of Cardiovascular Events Within 1 Year After Hip Fracture Surgery In The Elderly

Objective:To study the 1-year mortality and independent risk factors of the elderly patients with hip fracture,and the incidence and independent risk factors of perioperative cardiovascular events.Methods:Part I: we collected the general data of the elderly hip fracture patients admitted to our hospital from January 2012 to December 2016,and divide into survival group and death group according to whether they died one year after operation.According to single factor analysis,the differences of 10 indexes between the two groups in age,gender,fracture type,coexisting disease,coexisting disease number(? 4),preoperative waiting time,anesthesia mode,operation mode,hospital stay time and postoperative adverse cardiac events were compared?Moreover,the index with statistical significance(P < 0.05)were analyzed by multi factor Logistic regression analysis to determine the operation of elderly hip fracture patients mortality and independent risk factors.Part II: we collected the general data of elderly hip fracture patients admitted to our hospital from January 2012 to December 2016.According to whether cardiovascular events occur 30 days after operation,they are divided into two groups: the group with adverse cardiac events and the group without adverse cardiac events.By single factor analysis,the differences of age,gender,fracture type,coexisting diseases,number of coexisting diseases(? 4),waiting time before operation,anesthesia mode,length of stay of operation mode and other related factors were compared between the two groups.The indexes with statistical significance(P < 0.05)were analyzed by multi factor Logistic regression analysis to determine the incidence of perioperativecardiovascular events in elderly hip patients Independent risk factors.Results:In the first part,from January 2012 to December 2016,a total of 1350 elderly hip fracture patients were admitted,and 1004 elderly people over 60 years of age met the inclusion criteria.158 cases died one year after operation,the mortality rate was 15.74%.Single factor analysis showed that age(P = 0.000),gender(P = 0.001),fracture type(P =0.034),coronary heart disease(P = 0.005),arrhythmia(P = 0.009),dementia(P = 0.015),COPD(P = 0.026),cardiac insufficiency(P = 0.018),pulmonary infection(P = 0.001),number of coexisting diseases ? 4(P = 0.003),anesthesia(P = 0.018),length of stay(P =0.000)and postoperative cardiac adverse events(P = 0.000)are the risk factors of one-year mortality in elderly patients with hip fracture.Postoperative cardiac adverse events is an independent risk factor for the death of elderly hip fracture patients one year after operation.In the second part,from January 2012 to December 2016,1350 elderly patients with hip fracture were admitted,1004 of them were over 60 years old who met the inclusion criteria,45 of them had cardiovascular events after operation,and the incidence of perioperative cardiovascular events was 4.48%.According to whether cardiovascular events occurred 30 days after operation,45 patients were divided into two groups: the group with adverse cardiac events and the group without adverse cardiac events.Single factor analysis showed that age(P = 0.000),hypertension(P = 0.042),coronary heart disease(P = 0.000),dementia(P = 0.012),renal insufficiency(P = 0.000),cardiac insufficiency(P = 0.003),number of coexisting diseases(? 4)(P = 0.016),waiting time before operation(P = 0.008),hospitalization time(P = 0.000)were related to cardiovascular adverse events during perioperative period.Multiple logistic regression analysis showed that the elderly(or = 1.085,95% CI = 1.033-1.139),chronic renal insufficiency(or = 5.296,95% CI = 2.172-12.910),cardiac insufficiency(or = 2.938,95%CI = 1.283-6.729),delayed operation(or = 3.682,95% CI = 1.110-12.220)were the independent risk factors of perioperative adverse cardiac events.Conclusion:The 1-year mortality rate of the elderly patients with hip fracture is 15.74%.Theelderly,male,dementia,cardiac insufficiency,long hospital stay and postoperative adverse cardiac events are the independent risk factors for the death of the elderly patients with hip fracture within 1 year.The incidence of perioperative cardiovascular adverse events in elderly patients with hip fracture was 4.48%.The elderly,renal insufficiency,cardiac insufficiency and delayed operation were independent risk factors of perioperative cardiovascular adverse events in elderly patients with hip fracture.