实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (2): 167-170.doi: 10.3969/j.issn.1003-9198.2025.02.013

• 临床研究 • 上一篇    下一篇

老年人工髋关节置换病人血红蛋白水平与住院时长的相关性研究

方玮, 徐成振, 苏志惠, 孙延桃, 蒋志刚, 李怀木, 徐绍俊, 杨文贵, 王芳, 刘军军   

  1. 210039 江苏省南京市,南京梅山医院骨科(方玮,徐成振,苏志惠,孙延桃,蒋志刚,李怀木,徐绍俊,杨文贵,王芳);医学心理科(刘军军)
  • 收稿日期:2024-04-15 出版日期:2025-02-20 发布日期:2025-03-03
  • 通讯作者: 刘军军,Email:32572348@qq.com
  • 基金资助:
    南京市医学科技发展基金项目(YKK20814,YKK21216,YKK22264)

Correlation between hemoglobin level and hospital stay in elderly patients undergoing artificial hip arthroplasty

FANG Wei, XU Chengzhen, SU Zhihui, SUN Yantao, JIANG Zhigang, LI Huaimu, XU Shaojun, YANG Wengui, WANG Fang, LIU Junjun   

  1. Department of Orthopedics(FANG Wei, XU Chengzhen, SU Zhihui, SUN Yantao, JIANG Zhigang, LI Huaimu, XU Shaojun, YANG Wengui, WANG Fang); Department of Psychology(LIU Junjun), Nanjing Meishan Hospital, Nanjing 210039, China
  • Received:2024-04-15 Online:2025-02-20 Published:2025-03-03
  • Contact: LIU Junjun, Email: 32572348@qq.com

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摘要： 目的 探讨初次行人工髋关节置换术(primary hip arthroplasty,PHA)的老年病人术前Hb水平与术后住院时长的相关性。 方法 回顾性收集2016—2022年南京梅山医院137例≥65岁行PHA病人的基本信息及相关临床指标,采用多因素线性回归分析术后住院时长与术前Hb水平的相关性,使用广义相加混合模型和阈值饱和效应模型评估非线性关系并计算拐点值,再通过分段多因素线性回归模型评估两者间的独立分段效应。 结果 多因素线性回归分析结果显示,老年PHA病人术后住院时长与术前Hb水平呈负相关(β=－0.51,95%CI:－0.97~－0.05,P=0.031)。调整混杂因素后,广义相加混合模型曲线拟合结果显示,两者之间呈非线性相关关系,在Hb为95 g/L处存在一个拐点。当Hb<95 g/L时,二者间呈负相关关系(β=－0.52,95%CI:－0.85~－0.19,P=0.003);当Hb>95 g/L时,二者间相关性无统计学意义(P=0.482)。 结论 PHA老年病人术前Hb水平越低,术后住院时长延长的风险越高;95 g/L是老年PHA病人术后住院时间延长与否的Hb临界值。   

关键词: 老年人, 髋部骨折, 髋关节置换术, 术后住院时长, 血红蛋白, 回顾性队列研究

Abstract: Objective To investigate the correlation between the level of preoperative hemoglobin(Hb) and postoperative hospital stay in the elderly patients undergoing primary hip arthroplasty(PHA). Methods The basic information and related clinical data of 137 patients aged ≥65 years who underwent PHA in Nanjing Meishan Hospital from 2016 to 2022 were retrospectively collected. Multivariate linear regression was used to analyze the correlation between postoperative hospital stay and preoperative Hb level. Non-linear relationship was assessed by generalized additive mixed model and threshold effect model. Piecewise regression was used to evaluate segmented effect of Hb on hospital stay. Results Multiple linear regression analysis showed a negative correlation between hospital stay and preoperative Hb level in PHA patients(β=－0.51, P=0.031). After adjusting confounding factors, the results of the generalized additive mixed model curve fitting showed a nonlinear relationship between Hb level and hospital stay, with an inflection point at Hb 95 g/L. When the level of Hb was <95 g/L, there was a negative correlation between Hb and hospital stay(β=－0.52, P=0.003); When the level of Hb was >95 g/L, the correlation between the two factors was not statistically significant(P=0.482). Conclusions The decrease of preoperative Hb level shows significant effects on hospital stay in the elderly patients undergoing PHA, and 95 g/L is the threshold of Hb for prolonging hospital stay in PHA patients.

Key words: aged, hip fracture, primary hip arthroplasty, hospital stay, hemoglobin, retrospective cohort study

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