geriatric hip fracture
Conditions
Interventions
Intervention group:Prone position intervention + symptomatic treatment
Control group:Symptomatic treatment
Sponsors
Zhong Da Hospital Affiliated to Southeast University
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Aged >=65 years; 2.Patient informed consent and voluntary participation in clinical trial; 3.Patients with low-energy traumatic hip fracture within 2 weeks before admission; 4.Patients meet at least one of the following criteria at admission: (1)Type 2 Diabetes; (2)Have a history of chronic lung diseases such as COPD; (3)The time between admission to surgery more than 48 h; (4)ADL score <5, KATZ index is lower than GRADE A; (5)Patients with low daily activity and respiratory distress during mild activity; (6)Patients with low daily activity and respiratory distress during mild activity; (7)Oxygen partial pressure < 80mmHg or oxygen saturation <95% in non-oxygenated state on admission; (8)Admission hemoglobin <100g/L; (9)Admission albumin < 30 g/L; (10)A history of smoking and sleep apnea; (11)Other conditions confirmed to increase the risk of postoperative pulmonary complications. 5.Able to understand and cooperate to perform prone position operation and routine postoperative care; 6.Surgical treatment was selected with closed reduction of intertrochanteric fracture and internal fixation of intramedullary nail or partial/total hip arthroplasty.
Exclusion criteria
Exclusion criteria: 1.Patients treated conservatively or refused to participate in clinical trials; 2.Patients with cognitive impairment, severe weakness or obesity who cant roll over and those who cant tolerate prone position; 3.Have life-threatening organ dysfunction, decompensation, inability to disengage from guardianship, non-invasive/invasive mechanical ventilation; 4.The number of comorbidities more than 5 or the waiting time for operation and hospitalization prolonged substantially due to comorbidities; 5.Preoperative diagnosis of pneumonia, pulmonary embolism, atelectasis, pneumothorax, pleural effusion and other PPCs; 6.Osteosarcoma, multiple myeloma, and other kinds of pathological fractures; 7.Patients with multiple fractures and multiple injuries; 8.Bilateral hip fractures; 9.Revision of hip surgery; 10.Previous major heart and lung surgery; 11.A disorder of immune function caused by various causes (malignant tumors, autoimmune diseases using chemotherapy, long-term hormone use).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Oxygenation index, oxygen partial pressure and oxygen saturation in arterial blood gas under deoxygenation;Incidence of postoperative pulmonary complications; | — |
Secondary
| Measure | Time frame |
|---|---|
| Length of postoperative hospital stay;Partial pressure of carbon dioxide;White blood cell count;Blood lactic acid;Mortality;C-reaction protein; | — |
Countries
China
Contacts
Public ContactRui Yunfeng
Zhong Da Hospital Affiliated to Southeast University
Outcome results
None listed