[Risk factors of postoperative stroke in elderly patients with hip fracture].

Objective: To study the risk factors of stroke after of elderly patients with hip fracture after operation.

Methods: From March 2012 to June 2017, 500 elderly patients with hip fracture who underwent hip replacement were selected, including 286 males and 214 females, aged from 60 to 76 years old with an average of (68.49±11.85) years. They were divided into stroke group with 30 cases and control group with 470 cases according to the occurrence of acute stroke within two weeks after operation. The general data and serum contents of cytokines IL-1, IL-6, IL-10 and TNF-α were compared between the two groups. The overall survival of the two groups were followed up.

Results: There was no significant difference in sex, age, anesthesia method, operation time, intraoperative blood loss, preoperative IL-1, IL-6, IL-10 and TNF-α contenta between stroke group and control group(>0.05). The prevalence of hypertension, diabetes mellitus, atrial fibrillation, intraoperative hypotension, IL-1, IL-6, IL-10 and TNF-α contenta 1 day and 3 days after operation of stroke group were significantly higher than control group(<0.05);up to the date of follow-up, the cumulative survival rate of stroke patients were significantly lower than those of the control group(<0.05). Logistic regression analysis showed that intraoperative hypotension, elevated contents of serum IL-1 and TNF-α at 1 and 3 days after operation were risk factors for acute stroke.

Conclusion: Postoperative stroke in elderly patients with hip fracture affects the prognosis of the disease. The increase of inflammatory cytokines IL-1 and TNF-α after operation is an independent risk factor for stroke.