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Impact of diabetes on the prognosis of hip fracture： a cohort study in the Chinese population

Chinese Medical Journal 2013年第5期126卷 813-818页

作者： WANG Hong LV Yan-wei LAN Ling ZHANG Quan CHEN Hai-ling ZHANG Guo-ying DENG Li-li LI Ju-fen Department of Endocrinology Beijing Jishuitan Hospital Beijing 100035 China Department of Traumatology and Orthopaedics Beijing Jishuitan Hospital Beijing 100035 China Biostatistics and Clinical Epidemiology Research Office ResearchInstitute of Traumatology and Orthopaedics of Beijing & BeijingJishuitan Hospital Beijing 100035 China

Background Diabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ambulatory ability recovery in individuals with hip fracture, and to determine whether changes could be made to improve treatment outcome. Methods The study included 707 hip fracture patients treated at Beijing Jishuitan Hospital between July 2009 and December 2010. The medical history and perioperative complications were compared between non-diabetic and diabetic groups. Length of stay, days awaiting surgery, and days of hospitalization after surgery were also analyzed. Ambulatory ability was compared at 1-year follow-up using the Chi-square test and Fisher＇s exact test. An independent Student＇s t-test was used to compare normally distributed continuous data. Results Patients with diabetes were more likely than non-diabetic patients to develop cardiac perioperative complications （8.9% vs. 3.0%, P=0.021）, urinary tract infections （12.0% vs. 2.8%, P 〈0.001）, and gastrointestinal symptoms （15.0% vs. 6.8%, P=0.003）. No difference in perioperative complications was observed between the groups. Days awaiting surgery and length of hospital stay were both longer in the diabetic group （（8.0＋5.1） vs. （6.2＋3.7） days and （16.5＋3.8） vs. （13.3＋3.8） days, P 〈0.001, respectively）. Before the occurrence of fracture, patients with diabetes were less likely to be ambulatory outdoors （71.9% vs. 85.9%, P 〈0.001） and had more restricted walking ability. After at least 1-year follow-up, similar proportions of patients in the non-diabetic and diabetic groups （16.1% and 15.9%, respectively）, who were able to ambulate outdoors before the fracture, became housebound till the final follow-up. Conclusions Diabetics are at increased risk of specific complications and have a longer time to surgery and longer in-hospital stay, but generally have similar recovery to non-diabetics ther

关键词： diabetes mellitus hip fractures perioperative complications," mobility limitation

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