Risk factors of perioperative heart failure in elderly patients with femoral shaft fracture / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To study the risk factors of perioperative heart failure in the elderly patients with femoral shaft fracture by the regression analysis, so as to provide relevant clinical reference.</p><p><b>METHODS</b>From July 2012 to April 2017, 143 elderly patients with femoral shaft fracture who underwent surgical treatment in our hospital were retrospectively studied. Among them, 25 patients with perioperative heart failure included 10 males and 15 females with a mean age of (77.2±12.5) years old; 118 patients without heart failure included 54 males and 64 females with a mean age of (71.1±10.6) years old. The data of the time from injury to operation, hypertension history, heart disease history, disturbance of consciousness, preoperative renal function, operation method, operation time, anesthesia mode, perioperative fluid volume difference, perioperative pain score, postoperative hemoglobin were collected and recorded. The various factors of the two groups were compared, and a multiple factor Logistic regression analysis was performed on the meaningful results in order to identify the independent risk factors.</p><p><b>RESULTS</b>Univariate analysis showed that age, heart disease history, preoperative renal function and perioperative fluid volume had statistical difference between the two groups(<0.05). Multivariate analysis showed that the independent risk factors of perioperative heart failure were age[=0.016,=2.789(1.208, 6.439)], heart disease history[=0.011,=2.878(1.269, 6.527)], preoperative renal function[=0.043,=2.410(1.027, 5.654)], the perioperative fluid volume difference[=0.022,=4.215(1.230, 14.439)].</p><p><b>CONCLUSIONS</b>The age, heart disease history, preoperative renal function and perioperative fluid balance are the risk factors of perioperative heart failure in elderly patients with femoral fracture. During the perioperative period, we should pay full attention to and evaluate the hazards of these risk factors and adopt effective and effective prevention and treatment measures.</p>