Complication of Anesthesia
Risk factors for in-hospital cardio-cerebrovascular events and 1-year mortality following lower extremity fracture surgery in elderly patients
Zhang Jiangang, Ni Kun, Hou Bailing, Yu Wanyou, Yang Lei, Gu Xiaoping, Ma Zhengliang
Published 2018-03-20
Cite as Chin J Anesthesiol, 2018,38(3): 266-270. DOI: 10.3760/cma.j.issn.0254-1416.2018.03.004
Abstract
ObjectiveTo identify the risk factors for in-hospital cardio-cerebrovascular events and 1-year mortality following lower extremity fracture surgery in elderly patients.
MethodsFour hundred and thirty patients, aged ≥ 65 yr, undergoing elective lower extremity fracture surgery from January 2010 to December 2014, were selected.Age, gender, American Society of Anesthesiologists (ASA) physical status, preoperative comorbidities (diabetes mellitus, cardio-cerebrovascular events and hemiplegia), preoperative anemia, surgical site (hip and femur, knee joint and the site below the knee), anesthesia method (general anesthesia, neuraxial anesthesia), surgery time, intraoperative hypertension and hypotension, intraoperative blood loss, postoperative Hb≤90 g/L in hospital and volume of postoperative drainage, postoperative pneumonia and admission to the intensive care unit after operation were recorded.The patients were divided into either cardio-cerebrovascular event group or non-cardio-cerebrovascular event group according to whether the patients developed cardio-cerebrovascular events after surgery in hospital.The patients were divided into either survival group or dead group according to the living status 1 yr after surgery.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the risk factors for in-hospital cardio-cerebrovascular events and 1-year mortality following lower extremity fracture surgery.
ResultsThree hundred and seventy-two patients completed the study.Among the 372 patients, 35 patients developed postoperative cardio-cerebrovascular events in hospital, and the incidence was 9.4%, logistic regression analysis showed that the preoperative cardio-cerebrovascular diseases and ASA physical status ≥ Ⅲ were risk factors for in-hospital postoperative cardio-cerebrovascular events.Thirty-three patients died within 1 yr after surgery, the mortality rate was 8.9%, and logistic regression analysis showed that age≥75 yr, preoperative hemiplegia and development of cardio-cerebrovascular events after surgery in hospital were postoperative 1-year mortality-related risk factors.
ConclusionPreoperative cardio-cerebrovascular diseases and ASA physical status ≥ Ⅲ are the independent risk factors for in-hospital cardio-cerebrovascular events following lower extremity fracture surgery in elderly patients; age≥75 yr, preoperative hemiplegia and in-hospital postoperative cardio-cerebrovascular events are the independent risk factors for 1-year mortality after surgery.
Key words:
Aged; Fractures, bone; Postoperative complications; Risk factors
Contributor Information
Zhang Jiangang
Drum Tower Clinical College, Nanjing Medical University, Nanjing 210008, China
Ni Kun
Drum Tower Clinical College, Nanjing Medical University, Nanjing 210008, China
Hou Bailing
Drum Tower Clinical College, Nanjing Medical University, Nanjing 210008, China
Yu Wanyou
Department of Anesthesiology, Affiliated Jiangning Hospital, Nanjing Medical University, Nanjing 211100, China
Yang Lei
Department of Anesthesiology, Affiliated Jiangning Hospital, Nanjing Medical University, Nanjing 211100, China
Gu Xiaoping
Drum Tower Clinical College, Nanjing Medical University, Nanjing 210008, China
Ma Zhengliang
Drum Tower Clinical College, Nanjing Medical University, Nanjing 210008, China
