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ID 61355
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Hongo, Takashi Emergency Department, Okayama Saiseikai General Hospital
Naito, Hiromichi Department of Emergency, Critical Care, and Disaster Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine ORCID Kaken ID publons
Fujiwara, Toshifumi Emergency Department, Okayama Saiseikai General Hospital
Inaba, Mototaka Department of Emergency, Critical Care, and Disaster Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine
Fujisaki, Noritomo Department of Emergency, Critical Care, and Disaster Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine
Nakao, Atsunori Department of Emergency, Critical Care, and Disaster Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Kaken ID
Abstract
Aim
Femoral neck fractures in elderly patients needing oxygen therapy are often encountered in the emergency department. This single‐center, retrospective, observational study aimed to examine the frequency, cause, and factors related to hypoxia in elderly patients with femoral neck fractures.
Methods
We analyzed data from 241 patients admitted to Okayama Saiseikai General Hospital (Okayama, Japan) from April 2016 to March 2019. Hypoxia was defined as PaO2 / FiO2 ratio under 300. The independent factors for hypoxia were determined by multiple logistic regression analysis.
Results
There were 194 patients who met the study inclusion criteria, 148 in the non‐hypoxia group and 46 in the hypoxia group. The hypoxia group included patients with pneumonia (n = 3), chronic obstructive pulmonary disease (n = 2), pulmonary edema (n = 1), and pulmonary embolization (n = 1). The cause of hypoxia was undetermined in 39 cases. However, occult fat embolism syndrome was suspected in 29 of these 39 cases based on Gurd and Wilson criteria after considering clinical examination results. Barthel indexes were significantly lower in the hypoxia group on discharge. Age (adjusted odds ratio [OR] 1.07; 95% confidence interval [CI], 1.00–1.14; P = 0.038), D‐dimer (adjusted OR 1.02; 95% CI, 1.00–1.03; P = 0.005), and transtricuspid pressure gradient (adjusted OR 1.03; 95% CI, 1.00–1.07; P = 0.015) were independently associated with the hypoxia.
Conclusion
We found that hypoxia, including undetermined hypoxia, was commonly encountered in the emergency department. Hypoxia in elderly patients with femoral neck fractures was associated with age, D‐dimer, and transtricuspid pressure gradient and needs further investigation.
Keywords
D-dimer
geriatric
hypoxia
injury
TRPG
Published Date
2020-12-20
Publication Title
Acute Medicine and Surgery
Volume
volume7
Issue
issue1
Publisher
Wiley
Start Page
e618
ISSN
2052-8817
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© 2020 The Authors.
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publisher
PubMed ID
DOI
Web of Science KeyUT
Related Url
isVersionOf https://doi.org/10.1002/ams2.618
License
https://creativecommons.org/licenses/by-nc/4.0/
Funder Name
Japan Society for the Promotion of Science
助成番号
JP 18K08887