摘要
目的:通过Meta分析明确老年髋部骨折患者并发心力衰竭的危险因素。方法:通过计算机检索PubMed、Embase、Cochrane Library、Medline、Web of Science、中国知网、中国生物医学文献数据库、万方和维普等多个国内外数据库与老年髋部骨折患者围手术期心力衰竭危险因素相关的研究,检索时限为建库至2021年10月,由2位研究者对文献进行筛选、资料提取和质量评价,并使用统计软件Revman5.3进行Meta分析。结果:本研究纳入了17篇文献,共计176608例患者,24个相关危险因素,具有统计学意义的危险因素包括心脏病史(OR=4.47,95%CI 3.56~5.62)、围手术期出入量正平衡(OR=5.99,95%CI 3.30~10.87)、贫血(OR=3.78,95%CI 2.50~5.69)、合并症数量>4种(OR=6.21,95%CI 3.71~10.38)、电解质紊乱(OR=7.40,95%CI 3.77~14.54)、术前认知功能(OR=3.60,95%CI 1.39~9.31)和美国麻醉师协会(ASA)分级≥3级(OR=4.73,95%CI 2.73~8.12),各组差异有统计学意义(P<0.05)。结论:心脏病史、围手术期出入量正平衡、贫血、合并症数量>4种、电解质紊乱、术前认知功能障碍和ASA分级≥3级是老年髋部骨折患者围手术期并发心力衰竭的危险因素。
Objective To identify the risk factors of heart failure in elderly patients with hip fracture by Meta-analysis.Methods The clinical studies on perioperative heart failure in elderly patients with hip fracture were searched by computer in Pubmed,EMbase,Cochrane Library,Medline,Web of Science,CNKI,CBM,Wanfang and VIP database.The retrieval period was from the establishment of the databases to October 2021.The literature screening,data extraction and quality evaluation were completed by two researchers,and the selected literature were statistically analyzed by RevMan5.3 software.Results A total of 17 articles were included in this study,involving 176611 patients and 24 related risk factors.Cardiac history(OR=4.47,95%CI 3.56-5.62),positive balance of perioperative inflow and outflow(OR=5.99,95%CI 3.30-10.87),anemia(OR=3.78,95%CI 2.50-5.69),and the number of complications>4(OR=6.21,95%CI 3.71-10.38),electrolyte disorder(OR=7.40,95%CI 3.77-14.54),preoperative cognitive impairment(OR=3.60,95%CI 1.39-9.31)and American Society of Anesthesiologists(ASA)grade≥3(OR=4.73,95%CI 2.73-8.12)were statistically significant risk factors(P<0.05).Conclusions Cardiac history,positive balance of perioperative inflow and outflow,anemia,number of complications>4,electrolyte disorder,preoperative cognitive impairment and ASA grade≥3 were the risk factors of perioperative heart failure in elderly patients with hip fracture.
作者
田苗
丁俊琴
周琪
王治乾
杜霈
付明明
李秀婷
Tian Miao;Ding Junqin;Zhou Qi;Wang Zhiqian;Du Pei;Fu Mingming;Li Xiuting(Trauma Emergency Center,the Third Hospital of Hebei Medical University,Key Laboratory of Biomechanics of Hebei Province,Shijiazhuang 050000,China;Department of Nursing,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Infection Control,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《中国实用护理杂志》
2022年第22期1748-1756,共9页
Chinese Journal of Practical Nursing
基金
河北省财政厅老年病防治基金项目(2089901)。
