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JAMA Intern Med:手术可降低老年痴呆患者髋骨骨折后死亡风险

2018-05-10 zhangfan MedSci原创

研究认为,对于髋骨折痴呆患者,接受髋部骨折外科修复手术可降低患者死亡风险,改善疼痛及压力性溃疡症状

对于髋部骨折的老年痴呆患者,是否进行骨折修复手术是一大临床难题。近日研究人员考察手术对骨折患者结果的影响。

总计3083名痴呆并发髋骨折患者参与研究,根据医疗保险记录确定患者是否接受过手术,利用COX比例风险考察骨折老人接受手术对死亡率的影响。

参与者平均年龄84.2岁,女性占79.2%,28.5%的参与者可自行活动,84.8%的患者接受手术。6个月随访期间,手术组824人(31.5%)以及非手术组252人(53.8%)死亡,手术可降低患者死亡风险(aHR 0.88)。在2007名存活6个月以上人群中,手术组患者疼痛(29.0% vs 30.9%,aHR=0.64)和压力性溃疡(11.2% vs 19.0%,aHR=0.64)发病率较低。组间抗精神病药物和身体约束的使用差异不显著,但幸存者的自主运动能力显著降低。

研究认为,对于髋骨折痴呆患者,接受髋部骨折外科修复手术可降低患者死亡风险,改善疼痛及压力性溃疡症状。

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