关键词: 老年骨折, 术前, 急性脑梗死, 流行病学

Abstract:

Objective To investigate the epidemiological characteristics of in-hospital acute cerebral infarction in elderly patients with fractures before operation. Methods A total of 18,435 elderly patients undergoing fracture surgery in our hospital from January 1, 2016 to October 31, 2021 were retrospectively investigated, among whom 58 patients had acute cerebral infarction before surgery. Their medical records included general information, first detected laboratory indicators on admission, time from injury to admission, time from admission to operation, time of cerebral infarction, etc. The epidemiological status of preoperative acute cerebral infarction in patients was analyzed, and the mechanism and risk factors of preoperative acute cerebral infarction in elderly patients with fractures were described and analyzed. Results The incidence of in-hospital acute cerebral infarction in elderly patients with fractures was 0.314%. Among 58 recruited patients, there were 19 males (32.8%) and 39 females (67.2%), with a male to female ratio of 1∶2.05. The mean age of them was (74.0±1.3) years, and 40 patients (69.0%) were over 75 years.There were 47 cases of hip fractures (81.0%), 3 cases of distal femoral fractures (5.2%), 3 cases of humeral fractures (5.2%), 2 cases of femoral shaft fractures (3.4%), 2 cases of olecranon fractures (3.4%) and 1 case of proximal tibia fracture (1.7%). The onset time of cerebral infarction ranged 1-7 days, and 35 cases (60.3%) occurred within 72 hours. Most of the abnormal laboratory indicators detected for the first time on admission were hemoglobin, serum C-reactive protein, serum homocysteine and serum albumin. Anemia was the most-common complication during hospitalization (70.7%), followed by lower extremity deep vein thrombosis (56.9%), electrolyte disturbance (43.1%), hypoproteinemia (41.7%) and pulmonary infection (37.9%). Conclusion Acute cerebral infarction mostly occurs within 72 hours in elderly patients with fractures, and hip fracture is the more common type in female patients ≥75 years old. Laboratory indicators detected for the first time on admission should be thoroughly evaluated, and targeted measures should be taken to prevent complications and reduce the incidence of acute cerebral infarction before operation.

Key words: elderly fracture, preoperative, acute cerebral infarction, epidemiology