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

摘要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 thereafter.

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作者单位 Department of Endocrinology,Beijing Jishuitan Hospital, Beijing 100035, China [1] Biostatistics and Clinical Epidemiology Research Office, Research Institute of Traumatology and Orthopaedics of Beijing & Beijing Jishuitan Hospital, Beijing 100035, China [2] Department of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China [3]
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DOI 10.3760/cma.j.issn.0366-6999.20122712
发布时间 2013-04-26(万方平台首次上网日期,不代表论文的发表时间)
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中华医学杂志(英文版)

中华医学杂志(英文版)

2013年126卷5期

813-818页

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