고령의 고관절부 골절 환자에서인공 고관절 반치환술 후 사망률 분석
The Analysis of Postoperative Mortality after Bipolar Hemiarthroplasty for Hip Fractures in the Elderly
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목적: 고령의 고관절부 골절환자에서 인공 고관절 반치환술 시행 후 발생한 사망률과 관련된 인자를분석하여 보고하고자 한다. 대상 및 방법: 1994년 3월부터 2010년 3월까지 고관절부 골절로 인공 고관절 반치환술을 시행한 75세 이상의 환자 246명 278예를 대상으로 하였으며 평균 연령은 83.7세(75-103세)였다. 연령, 성별,골절 형태, 동반 질환, ASA 등급, 골밀도, 수술 시기, 보행능력, 거주형태를 조사하여 수술 후 1년 내사망과 관련이 있는 인자들을 사망군과 비사망군으로 나누어 분석하였다. 결과: 수술 후 1년 사망률은 17.2%(48예)였고, 술 후 3개월까지 9.7%(27예), 4개월에서 6개월까지5.4%(15예), 7개월에서 1년까지 2.1%(6예)였다. 수술 후 1년 사망률은 지연된 수술, 높은 ASA 등급, 보행능력, 거주 형태 등의 영향을 받았으나 연령, 성별, 골밀도, 골절 형태 등과의 유의한 관계는 없었다. 결론: 고령의 고관절부 골절 환자에서 양극성 반치환술 후 사망률 연구에서 ASA 등급, 수술 시기, 보행 능력, 거주형태가 중요한 인자로 나타났다.
Abstract
Purpose: This study evaluated the rate of mortality and analyzed the associated risk factors in elderly patientstreated with bipolar hemiarthroplaty for the hip fractures. Materials and Methods: Between March 1994 and March 2010, the clinical records of 246 patients(278 cases)older than 75 years of age who underwent bipolar hemiarthroplaty after hip fractures were reviewed. The meanage of the subjects was 83.7 years(75-103 years). The relationship between the postoperative one year mortalityand the related factors (age, gender, type of hip fractures, the timing of surgery, the associated medical condition,ASA grade, osteoporosis, walking ability and residence type) were analyzed. The subjects were divided into thedead group and survivor group. Results: The mean postoperative mortality rate within 1 year was 17.2%(48 cases). The highest mortality ratewas observed at postoperative 3 months(9.7%, 27 cases), followed in order by between 4 and 6 months(5.4%, 15cases) and 7 and 12 months(2.1%, 6 cases). The postoperative mortality rate within 1 year was affected by thetiming of the operation, ASA grade, patient’s walking ability, and residence type, but there were no significantdifference of the other factors, such as age, gender, osteoporosis, and type of hip fractures. Conclusion: The ASA grade, timing of the operation, walking ability, and residence type are factors associatedwith the mortality rate in elderly patients with hip fractures.
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