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Yang Y.,Hebei Medical University | Zhao X.,Hebei General Hospital | Dong T.,Hebei Medical University | Yang Z.,Hebei Medical University | And 3 more authors.
Aging Clinical and Experimental Research | Year: 2016

Background: No formal systematic review or meta-analysis was performed up to now to summarize the risk factors of delirium after hip surgery. Aims: The present study aimed to quantitatively and comprehensively conclude the risk factors of delirium after hip surgery in elderly patients. Methods: A search was applied to CNKI, Embase, Medline, and Cochrane central database (all up to August 2015). All studies assessing the risk factors of delirium after hip surgery in elderly patients without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle–Ottawa Scale. Data were pooled and a meta-analysis was completed. Results: A total of 24 studies were selected, which altogether included 5364 patients with hip fracture. One thousand and ninety of them were cases of delirium occurred after surgery, suggesting the accumulated incidence of 24.0 %. Results of meta-analyses showed that elderly patients with preoperative cognitive impairment [odds ratio (OR) 3.21, 95 % confidence interval (CI) 2.26–4.56), advanced age (standardized mean difference 0.50, 95 % CI 0.33–0.67), living in an institution (OR 2.94; 95 % CI 1.65–5.23), heart failure (OR 2.46; 95 % CI 1.72–3.53), total hip arthroplasty (OR 2.21; 95 % CI 1.16–4.22), multiple comorbidities (OR 1.37; 95 % CI 1.12–1.68) and morphine usage (OR 3.01; 95 % CI 1.30–6.94) were more likely to sustain delirium after hip surgery. Females were less likely to develop delirium after hip surgery (OR 0.83; 95 % CI 0.70–0.98). Conclusions: Related prophylaxis strategies should be implemented in elderly patients involved with above-mentioned risk factors to prevent delirium after hip surgery. © 2016 Springer International Publishing Switzerland Source


Zhang B.,Hebei Medical University | Zhu Y.,Hebei Medical University | Zhu Y.,Key Laboratory of Biomechanics of Hebei Province | Zhang F.,Hebei Medical University | And 7 more authors.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Year: 2015

Background: This systematic review and meta-analysis aims to critically compare the outcomes of plate fixation (PF) versus intramedullary fixation (IF) for the treatment of mid-shaft clavicle fractures. Methods: Relevant original studies were searched in electronic databases of Medline, Embase, Cochrane central database and CNKI (all through October 2014). The study was performed according to the PRISMA statement. Studies that investigated the comparing effectiveness or complications between both groups and provided sufficient data of interest were included in this meta-analysis. Results: Thirteen studies fulfilling inclusion and exclusion criteria were included in this meta-analysis, which included 479 participants in PF group and 457 in IF group. Compared to PFs, IFs outperformed PFs associated with a reduced surgery time, a shorter incision, rapid union time, better shoulder function recovery at 6months and fewer complications of symptomatic hardware, refracture after hardware removal and hypertrophic scar. In other aspects such as functional recovery at 12months and 24months follow-up, shoulder motion range, complications of superficial infection,temporary brachial plexus lesion, nonunion, malunion, delayed union, implant failure, major revision needed, both techniques were comparable. Conclusions: The present evidence from this meta-analysis suggested that IF was a more advantaged method for the treatment of midshaft clavicle fractures. This present study might aid surgeons in making evidence-based decision about optimal surgical treatment of mid-shaft clavicular fracture. © Zhang et al.; licensee BioMed Central. Source


Zhu Y.,Hebei Medical University | Zhu Y.,Key Laboratory of Biomechanics of Hebei Province | Zhang F.,Hebei Medical University | Zhang F.,Key Laboratory of Biomechanics of Hebei Province | And 8 more authors.
Journal of Hospital Infection | Year: 2015

Many of the mooted risk factors associated with periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) remain controversial and are not well characterized. Online and manual searches were performed using Medline, Embase, Chinese National Knowledge Infrastructure and the Cochrane Central Database from January 1980 to March 2014). For inclusion, studies had to meet the quality assessment criteria of the CONSORT statement, and be concerned with evaluation of risk factors for PJI after TJA. Two reviewers extracted the relevant data independently and any disagreements were resolved by consensus. Fourteen studies were included in this meta-analysis. The following significant risk factors for PJI were identified: body mass index (both continuous and dichotomous variables); diabetes mellitus; corticosteroid therapy; hypoalbuminaemia; history of rheumatoid arthritis; blood transfusion; presence of a wound drain; wound dehiscence; superficial surgical site infection; coagulopathy; malignancy, immunodepression; National Nosocomial Infections Surveillance Score ≥2; other nosocomial infection; prolonged operative time; and previous surgery. Factors that were not significantly associated with PJI were: cirrhosis; hypothyroidism; urinary tract infection; illicit drug abuse; alcohol abuse; hypercholesterolaemia; hypertension, ischaemic heart disease; peptic ulcer disease; hemiplegia or paraplegia; dementia; and operation performed by a staff surgeon (vs a trainee). Strategies to prevent PJI after TJA should focus, in particular, on those patients at greatest risk of infection according to their individual risk factors. © 2014 The Healthcare Infection Society. Source


Liu S.,Hebei Medical University | Liu S.,Key Laboratory of Biomechanics of Hebei Province | Zhu Y.,Hebei Medical University | Zhu Y.,Key Laboratory of Biomechanics of Hebei Province | And 8 more authors.
Clinical Rehabilitation | Year: 2015

Objectives: To achieve a quantitative and comprehensive conclusion concerning the risk factors for the second contralateral hip fracture in elderly patients with initial hip fractures. Data Sources: This search was applied to Medline, Embase, Cochrane central database (all up to April 2014). Methods: All the studies on bilateral hip fractures in elderly patients published in English were reviewed and qualities of included studies were assessed using the Newcastle-Ottawa Scale. All the data were carefully and independently abstracted by two reviewers, any disagreement was settled by discussion. Data was pooled and a meta-analysis completed. Results: A total of 13 case-control studies were identified for the meta-analysis. The significant risk factors were female (odds ratio (OR), 1.30; 95% confidence interval (CI), 1.02-1.64), living in institutions (OR, 2.53; 95% CI, 1.33-4.85), osteoporosis (OR, 10.02; 95% CI, 5.41-18.57), low vision (OR, 2.09; 95% CI, 1.06-4.12), dementia (OR, 2.02; 95% CI, 1.54-2.65), dizziness (OR, 2.87; 95% CI, 1.42-5.87) cardiac diseases (OR, 1.33; 95% CI, 1.00-1.78) and respiration diseases (OR, 2.58; 95% CI, 1.22-5.47). No significant difference was found in admission age between patients with the unilateral hip fracture and the first hip fracture of bilateral hip groups (standardized mean difference, 0.02, 95% CI, -0.30 to 0.35]. Conclusions: Patients involved with female, living in institutions, osteoporosis, low vision, dizziness, dementia, respiration diseases and cardiac diseases were at risk for a second contralateral hip fracture after the initial hip fracture. © The Author(s) 2014. Source


Zhu Y.,Hebei Medical University | Zhu Y.,Key Laboratory of Biomechanics of Hebei Province | Tian Y.,Hebei Medical University | Tian Y.,Key Laboratory of Biomechanics of Hebei Province | And 8 more authors.
International Orthopaedics | Year: 2015

Purpose: This meta-analysis of randomised controlled trials (RCTs) aimed to investigate the comparative outcomes between plate fixation and intramedullary fixation for management of mid-shaft clavicle fractures. Methods: Relevant original studies were searched in electronic databases of PubMed, Medline, Embase and CNKI (all through October 2014). RCTs that investigated the effectiveness or complications between both groups and provided sufficient data of interest were included in this meta-analysis. Results: Five RCTs fulfilled inclusion and exclusion criteria and were included in this meta-analysis, with 128 participants in a plate fixation (PF) group and 157 in an intramedullary fixation (IF) group. Patients were followed up for at least one year in all the studies. Compared to PFs, IF is a better alternative for treatment of MSCFs than PF, with a reduced surgery time, a shorter incision, rapid union time, better shoulder function at one year and fewer complications such as infection, symptomatic hardware and hypertrophic scar. In other aspects such as complications of implant failure, refracture and nonunion, both techniques were comparable. Conclusions: If the surgery is indicated, intramedullary fixation has more advantages than plate fixation for treatment of mid-shaft clavicular fracture. This definitive conclusion could aid surgeons in making evidence-based decisions when selecting an optimal fixation pattern. © 2015, SICOT aisbl. Source

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