Clinical characteristics and risk factors of postoperative pneumonia after hip fracture surgery: a prospective cohort study

2016 ◽  
Vol 27 (10) ◽  
pp. 3001-3009 ◽  
Author(s):  
H. Lv ◽  
P. Yin ◽  
A. Long ◽  
Y. Gao ◽  
Z. Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hip Fracture ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Clinical Characteristics ◽  
Postoperative Pneumonia ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

scholarly journals Risk factors for extended length of stay following hip fracture surgery: A retrospective cohort study of patients aged 90 years and over in China

2019 ◽  
Author(s):  
Ling Lan ◽  
Li-jian Pei ◽  
Feifei Zhai ◽  
Yuelun Zhang ◽  
Jun Jing ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Retrospective Cohort ◽  
Binary Logistic Regression ◽  
Postoperative Pneumonia ◽  
Binary Logistic Regression Analysis ◽  
Hip Fracture Surgery ◽  
Extended Length ◽  
Potential Risk Factors ◽  
Fracture Surgery

Abstract Background Hip fractures are typical fractures in geriatric patients and are associated with a high risk of postoperative complications and extended length of stay (LOS) compared with other osteoporotic fractures, particularly among patients over age 90. We aimed to identify the risk factors for extended LOS (more than 14 days) in patients older than 90 years. Methods A single-centre retrospective cohort study was performed in 50 patients (over age 90) who experienced hip fracture between June 1, 2013, and August 31, 2017. Their medical records were retrospectively reviewed from the hospital’s electronic database. The baseline characteristics of the patients, intraoperative data and postoperative complications were collected for the assessment of potential risk factors. Univariate analysis and multivariate binary logistic regression analysis were performed to determine potential risk factors for extended LOS. Results The age of the patients in the cohort ranged from 90 to 101 years, and the analysis demonstrated that 70% (n = 35) of the patients experienced a complicated course of treatment with an in-hospital mortality rate of 4% (n = 2). The most common complication was the occurrence of postoperative pneumonia (38%). The median duration of hospital stay was 18 (IQR 11, 21) days. Multivariate binary logistic regression analysis showed that a LOS of more than 14 days was significantly associated with a lower mean diastolic blood pressure during surgery [odds ratio (OR) =0.86, 95% confidence interval (CI)=0.76-0.98, P = 0.018] and the occurrence of postoperative pneumonia (OR=8.95, 95% CI=1.45-55.3, P = 0.018). The occurrence of postoperative pneumonia was significantly associated with the neutrophil-to-lymphocyte ratio (NLR) at admission (D0) [odds ratio (OR) =1.20, 95% confidence interval (CI)=1.02-1.41, P = 0.029]. Neither the LOS nor postoperative pneumonia was found to be associated with the anaesthesia technique. Conclusions A lower mean diastolic blood pressure during surgery and the occurrence of postoperative pneumonia may extend the LOS in patients aged 90 years and over who undergo hip fracture surgery. The use of regional anaesthesia was not associated with a shorter LOS.

scholarly journals Incidence and risk factors of surgical site infection after intertrochanteric fracture surgery: A prospective cohort study

2020 ◽  
Vol 17 (6) ◽  
pp. 1871-1880
Author(s):  
Kuo Zhao ◽  
Junzhe Zhang ◽  
Junyong Li ◽  
Hongyu Meng ◽  
Zhongzheng Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Surgical Site Infection ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Intertrochanteric Fracture ◽  
Site Infection ◽  
Fracture Surgery

scholarly journals Cause of Death and Factors Associated With 5-Year Mortality After Hip Fracture Surgery

2020 ◽  
Author(s):  
Xiaowei Wang ◽  
Jianwen Zhao ◽  
Huayong Zheng ◽  
Jianzhen Zhang ◽  
Tiansheng Sun
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Cause Of Death ◽  
Clinical Characteristics ◽  
Pulmonary Infection ◽  
Common Cause ◽  
Factors Associated ◽  
Hip Fracture Surgery ◽  
Post Surgery ◽  
Fracture Surgery

Abstract Aim: the aims of this study were to identify the 5-year mortality rate after hip fracture, identify factors associated with this mortality, and identify the cause of death in these patients.Materials and Methods: A retrospective cohort study of geriatric patients (≥60 years of age) undergoing a hip fracture surgical procedure admitted to our institution between the 1 January 2012 and 31 December 2016 was performed. Demographic and clinical characteristics were collected. Patients or their careers were contacted by telephone or outpatient to ascertain their vital status, and cause of death if they had died at 5-year post-surgery. According to whether they were alive or death at 5-year post-surgery, patients were divided into survivor or non-survivor group. All variables including demographic data and clinical characteristics were compared for both survivors and non-survivors. Cox proportional hazards were used to determine independent risk factors for 5-year mortality. All cause of 5-year mortality in hip fracture were recorded.Result: A total of 327 patients with a median age of 80.00 years were included. 5-year mortality was 40.1%, and the death peak was concentrated during 6 months after surgery. The final multivariate model included 4 independent mortality risk factors: advanced age, stroke, albumin, delayed surgery, with an HR (95% confidence interval) 1.052(1.025-1.080), 1.612(1.104-2.353), 0.940(0.900-0.982), 1.638(1.072-2.498), respectively. Pulmonary infection, and cardiovascular disease were the most common cause of 5-year death.Conclusion: Our results showed that 5-year mortality was 40.1%. Advanced age, stroke, low albumin, and delayed surgery were associated with 5-year mortality after hip fracture surgery. Pulmonary infection, and cardiovascular disease were the most common cause of death.

scholarly journals The prevalence, risk factors and prognostic implications of dysphagia in elderly patients undergoing hip fracture surgery in Korea

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Seong-Eun Byun ◽  
Kyeu Back Kwon ◽  
Sang Ho Kim ◽  
Seung-Jae Lim
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Hip Fracture ◽  
Serum Albumin ◽  
Poor Prognosis ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Postoperative Pneumonia ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Abstract Background Dysphagia is prevalent in geriatric patients, such as elderly hip fracture patients, and is associated with a poor prognosis. This study investigated (1) the prevalence of dysphagia based on clinical screening and a video-fluoroscopic swallowing study (VFSS), (2) the risk factors of dysphagia, and (3) the prognostic implications of dysphagia in elderly patients (≥ 65 years) undergoing hip fracture surgery. Methods In this retrospective study, data from 393 female and 153 male patients ≥65 years of age who underwent surgery for a hip fracture between 2015 and 2018 were analysed. Patients who were considered at high risk of dysphagia after screening underwent a VFSS. To identify risk factors of dysphagia, demographic factors, the American Society of Anesthesiologists classification, past medical history, known risk factors of dysphagia, and factors associated with surgery were analysed using a binary logistic regression model. Odds ratios (ORs) of dysphagia for having poor prognosis including postoperative pneumonia, intensive care unit (ICU) admission, and death within 6 months after surgery were obtained by logistic regression. The association of postoperative pneumonia with poor prognosis was also analysed. Results Dysphagia was seen in 5.3% of hip fracture patients. In multivariate regression analysis, a serum albumin level < 3.5 g/dL was identified as a risk factor for dysphagia (OR [95%CI] = 3.13 [1.40, 7.01]). Dysphagia was identified as a risk factor for postoperative pneumonia in regression analysis after adjustment (OR [95%CI] = 3.12 [1.05, 9.27]). Postoperative pneumonia was significantly associated with ICU admission (OR [95% CI] = 4.56 [1.85, 11.28]) and death within 6 months after surgery (OR [95% CI] = 2.56 [1.03, 6.33]). Conclusions Dysphagia in elderly hip fracture surgery patients was associated with postoperative pneumonia, a risk factor for poor outcomes including ICU admission and death within 6 months after surgery. A serum albumin level < 3.5 g/dL was identified as a risk factor for dysphagia. Therefore, diagnostic testing should be performed to detect dysphagia, especially in patients with a low serum albumin level. Finally, particular care should be taken to prevent postoperative complications in patients with dysphagia.

Risk factors for a second nonsimultaneous hip fracture in a prospective cohort study

2021 ◽  
Author(s):  
Ricardo Larrainzar-Garijo ◽  
Adolfo Díez-Pérez ◽  
Esther Fernández-Tormos ◽  
Daniel Prieto-Alhambra
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hip Fracture ◽  
Prospective Cohort Study ◽  
Prospective Cohort

scholarly journals Risk factors for new chronic opioid use after hip fracture surgery: a Danish nationwide cohort study from 2005 to 2016 using the Danish multidisciplinary hip fracture registry

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e039238
Author(s):  
Nina McKinnon Edwards ◽  
Claus Varnum ◽  
Søren Overgaard ◽  
Lone Nikolajsen ◽  
Christian Fynbo Christiansen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hip Fracture ◽  
Postoperative Treatment ◽  
Renal Diseases ◽  
First Year ◽  
Opioid Use ◽  
Hip Fracture Surgery ◽  
Chronic Opioid Use ◽  
Fracture Surgery

ObjectiveTo examine the risk factors for new chronic opioid use in elderly patients who underwent hip fracture surgery.DesignProspective population-based cohort study.Setting and participantsUsing Danish nationwide health registries, we identified all opioid non-user patients aged ≥65 years who had undergone hip fracture surgery from 2005 to 2016 and were alive within the first year following surgery.Main outcome measuresNew chronic opioid use defined by the dispensing of at least two prescription opioids within two of the last three quarters during the first year following surgery.ResultsWe identified 37 202 opioid non-user patients who underwent hip fracture surgery. Of these, 5497 (15%) developed new chronic opioid user within 1 year of surgery. Risk factors for new chronic opioid use were Body Mass Index (BMI) of <18.5 (adjusted OR (aOR) 1.22, 95% CI 1.09 to 1.36), BMI of 25.0–29.9 (aOR 1.12, 95% CI 1.04 to 1.21) and BMI of ≥30 (aOR 1.57, 95% CI 1.40 to 1.76) with BMI 18.6–24.9 as reference, a pertrochanteric/subtrochanteric fracture (aOR 1.27, 95% CI 1.20 to 1.34) with femoral neck fracture as reference, preoperative use (vs no-use) of non-steroidal anti-inflammatory drug (aOR 1.68, 95% CI 1.55 to 1.83), selective serotonin reuptake inhibitor (aOR 1.42, 95% CI 1.32 to 1.53), antidepressants (aOR 1.36, 95% CI 1.24 to 1.49), antipsychotics (aOR 1.21, 95% CI 1.07 to 1.35), corticosteroids (aOR 1.54, 95% CI 1.35 to 1.76), statins (aOR 1.09, 95% CI 1.02 to 1.18), antibiotics (aOR 1.32, 95% CI 1.22 to 1.42), antiosteoporosis drugs (aOR 1.33, 95% CI 1.19 to 1.49) and anticoagulatives (aOR 1.24, 95% CI 1.17 to 1.32). Presence of cardiovascular comorbidities, diabetes, gastrointestinal diseases, dementia, chronic obstructive pulmonary disease or renal diseases was further identified as a risk factor.ConclusionIn this large nationwide cohort study, we identified several risk factors associated with new chronic opioid use after hip fracture surgery among patients who were alive within the first year following surgery. Although not all factors are modifiable preoperative, this will allow clinicians to appropriately counsel patients preoperatively and tailor postoperative treatment.

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