| Summary: | 碩士 === 中臺科技大學 === 醫療暨健康產業管理系碩士班 === 102 === Introduction:
Proximal femoral fractures, including femoral neck fractures, intertrochanteric fractures and subtrochanteric fractures, often occur in people aged 60 or older and will cause patient’s immobility, severe pain and affect their quality of life. This study aims to compare the failure rates within two years that pateints with proximal femoral fracture treat with metal internal fixation or artificial hip arthroplasty in people aged more than 60 years or older in Taiwan.
Materials and Methods:
This study was a secondary analysis of data that used the database, from 2004 to 2008 National Health Insurance database of academic research hospital data in National Health Research Institutes, for analysis. In the study, we selected the patients, more than 60 years of older, with proximal femoral fractures for study. The methods of statistics used descriptive statistical with SPSS17.0, t-test and logistic regression analysis.
Results:
The number of people with femoral neck fractures, intertrochanteric fractures, subtrochanteric fractures and proximal femoral fractures for hospitalization were 40051, 35130, 2767 and 77948 people between 2004-2008. These patients treated with metal internal fixation and failure rates were 10.6%, 5.9%, 12.0% and 7.2%. Patients treated with hip arthroplasty with lower surgical failure rates, 4.0%, 5.2%, 2.0% and 4.1%. In different levels of care of medical institutions, the highest surgical failure rate is regional hospitals. The highest surgical failure rates of top three division of National Health Insurance Administration were respectively Taipei division, Central division and Southern division.
Conclusion:
There are 5 main risk factors affecting surgical failure for proximal femoral
fractures: age, gender, fracture sites, types of surgery and level of care of the hospital. There are about 2.7% reductions in the risks of surgical failure for every increment of one year of the patient’s age. The surgical failure rates were lower in men than women, about 0.88 times that of women’s. The surgical failure rates of extracapsular femoral fractures were lower than femoral neck fractures, about 0.76 times. The surgical failure rates for patient who received metal internal fixation were higher than patient received hip arthroplasty, about 2.4 times. There were different surgical failure rates in hospitals with different levels of care. Compared to medical centers, the surgical failure rates were higher in regional hospitals, up to 1.03 times, and in local hospitals, about 1.15 times.
|
|---|
