Influencing Factors and Perioperative Effects of Frailty in Elderly Patients with Hip Fracture

JIN Kaifeng; ZHONG Weitao

doi:10.3969/j.issn.2095-3097.2024.06.012

Abstract：Objective To investigate the influencing factors and perioperative effects of frailty in elderly patients with hip fracture.Methods Elderly patients with hip fracture treated in Department of Orthopedics,Beijing electric power hospital of state Grid corporation of China from January 2021 to January 2024 were selected as the study object (308 cases),and the patients were divided into the frailty group(n=90) and the non-frailty group(n=218) based on the frailty scale.The clinical characteristics of the two groups were compared,and the influencing factors of frailty in elderly patients with hip fracture and its influence on the perioperative period of the patients were analyzed.Results Among the308 elderly patients with hip frac-ture,90 (29.22％) and 218 (70.78％) were associated with fthenia before operation.Compared with the non-fthenic group,the age,the rate of underlying diseases (hypertension,diabetes,chronic obstructive pulmonary disease),the rate of depres-sion,the rate of cognitive impairment,and the American Society of Anesthesiologists (ASA) rating of patients in the fthenic group were significantly increased,while the preoperative plasma hemoglobin (HB) concentration and plasma albumin (ALB) concentration were significantly decreased,with statistical significance (all P<0.05).Logistic multivariate regression analy-sis showed that old age (OR=1.540,95％CI:1.187-1.999,P<0.01),hypertension (OR=1.857,95％CI:1.262～2.732,P<0.01),chronic obstructive pulmonary disease (OR=2.040,95％CI:1.468～2.836,P<0.01),depression (OR=1.846,95％CI:1.035～3.291,P<0.01),cognitive impairment (OR=1.691,95％CI:1.013-2.819,P<0.01),preoperative ALB decreased (OR=0.605,95％CI:0.407-0.899,P<0.01) were independent risk predictors of frailty in elderly patients with hip fracture.Compared with the non-fateful group,the proportion of delayed operation,duration of anesthesia,duration of operation,intraoperative blood loss,duration of hospitalization and proportion of patients admitted to intensive care department after surgery in fateful group were significantly increased,with statistical significance (all P<0.05).Compared with non-frailty group,the incidence of postoperative total complications,pulmonary infection rate and low-er limb thrombosis rate in frailty group were significantly increased,with statistical significance (all P<0.05).Conclusion Elderly patients with hip fracture have a high incidence of concurrent frailty,and its risk factors include old age,hyperten-sion,diabetes,chronic obstructive pulmonary disease,depression and cognitive impairment.Patients with concurrent frailty are more difficult to operate,have a high risk of postoperative complications,and have long postoperative rehabilitation.Early identification and effective intervention of patients with frailty can promote perioperative rehabilitation of patients.