| アブストラクト | INTRODUCTION: The efficacy of early surgery in preventing complications among Japanese elderly patients with hip fractures requires further investigation. This study aims to use a comprehensive Japanese hip fracture case database to determine whether surgery within the day of admission and the following day reduces the incidence of complications and mortality during hospitalization in elderly hip fracture patients. MATERIALS AND METHODS: We retrospectively analyzed the Japanese National Administrative DPC (Diagnosis Procedure Combination) database from April 2016 to March 2022. Approximately 1100 DPC-affiliated hospitals consistently provided medical records with consent for research. The study investigated the association between postoperative pneumonia, deep vein thrombosis, pulmonary embolism, and mortality during hospitalization after propensity score matching, focusing on surgeries conducted on the day of admission and the following day. RESULTS: After one-to-one propensity score matching for age, gender, and comorbidity, we identified 146,441 pairs of patients who underwent surgery either within the day of admission and the following day or after the third day of admission. Surgery on the third day or later was independently associated with increased risks of pneumonia, deep vein thrombosis, pulmonary embolism, and mortality during hospitalization with risk ratios of 1.367 (95% CI 1.307-1.426), 1.328 (95% CI 1.169-1.508), 1.338 (95% CI 1.289-1.388), and 1.167 (95% CI 1.103-1.234), respectively. CONCLUSION: A comprehensive study of elderly Japanese patients with hip fractures in the DPC database showed that surgery on admission and the following day is crucial for preventing complications like pneumonia, deep vein thrombosis, pulmonary embolism, and mortality during hospitalization. |
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| ジャーナル名 | Journal of bone and mineral metabolism |
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| 投稿日 | 2024/7/11 |
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| 投稿者 | Mori, Yu; Tarasawa, Kunio; Tanaka, Hidetatsu; Mori, Naoko; Fushimi, Kiyohide; Fujimori, Kenji; Aizawa, Toshimi |
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| 組織名 | Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine,;1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.;yu-mori@med.tohoku.ac.jp.;Department of Health Administration and Policy, Tohoku University Graduate School;of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.;Department of Radiology, Akita University Graduate School of Medicine, 1-1-1;Hondo, Akita, 010-8543, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku,;Tokyo, 113-8519, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38987506/ |
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