改良前后p-possum评分系统预测老年人低能量髋部骨折围手术期死亡率的对比分析-comparative analysis of p - possum scoring system in predicting perioperative mortality of low energy hip fracture in the elderly before and after improvement.docxVIP

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2018-05-29 发布于上海
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改良前后p-possum评分系统预测老年人低能量髋部骨折围手术期死亡率的对比分析-comparative analysis of p - possum scoring system in predicting perioperative mortality of low energy hip fracture in the elderly before and after improvement.docx

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改良前后p-possum评分系统预测老年人低能量髋部骨折围手术期死亡率的对比分析-comparative analysis of p - possum scoring system in predicting perioperative mortality of low energy hip fracture in the elderly before and after improvement

ABSTRACTObjects:Theaimofthisstudyistoimprovethephysiologicalandoperativeseverityscorefortheenumeration(P-POSSUM)onPortsmouthmortalityandcomplicationsincidencebasedoncharacteristicoforthopaedicsadmittedpatientsandextensiveliteraturereviewing.WepredictedthemortalityrateofLow-energyhipfractureperioperativebyP-POSSUMscoringsystembeforeandafterimprovementrespectively,andanalyzedtherelationshipbetweenpredictedandactualvaluestodiscussthepredictingvalueofpostoperativemortalitybythisimprovedsystemMethods:The161hipfracturecasestreatedinourhospitalformJanuary2012toJune2014wereselected,including82caseswithfemoralneckfracturesand79caseswithintertrochantericfractures.Preoperativeandintraoperativedatawasextractalonebytworesearchersindependentlyaccordingtomedicalrecords,andrecordedtheirP-POSSUMscoresbeforeandafterimproved.Ifthescoreswasdivergence,thenthefinalscoreresultswouldbedeterminedafterconsultationwiththirdresearchers.Linearregressionequationwasusedtocalculatethepredictedmortalityrateofpatients,andthenumbercalculatedbytheactualnumberofdeaths(O)minustheexpectednumberofdeaths(E)wasconductedtopredicttheclosenessoftheactualdeathandpredictdeath.Chi-squaretestwasusedtodetectthestatisticallysignificantbycomparingthepredictedvalueandtheactualvalue.Results:Atotalof161caseswereselectedinthispaper.Amongthem,82caseswithfemoralneckfracture(35males,47females,averageageis75.8±5.2),wereallusedhiprthroplasty.AccordingtotheresultsfortheGardenclassification:TypeⅠ,typeⅡ,typeⅢandtypeⅣwere2.4%,9.8%,3.7%,51.2%respectively.Thephysiologyscorewas21.5±5.8and22.4±8.2beforeandafterimprovedrespectively,andtherearesignificantdifferenttestbypairedttest(P0.05).Predictdeathsnumberwas4beforetheimprovedbyP-POSSUMpredictedmortalityformula,andtheactualdeathsnumberwas4too.Thedifferencewasnotsignificantcomparedbychi-squaretest(P0.05).Predictdeathsnumberwas6aftertheimprovedbyP-POSSUMpredictedmortalityformula.Thedifferencewasnotsignificantcomparedbychi-squaretest(P0.05)relatedtoactualnumber.Theaccuracydifferentbetwee