Risk factors and mortality of patients undergoing hip fracture surgery: a one-year follow-up study

AbstractOlder adult patients with hip fractures are 3–4 times more likely to die within one-year after surgery than general population. The study aimed to identify independent predictive factors associated with one-year mortality after hip fracture surgery. A prospective prognostic cohort study was performed. All patients aged ≥65 years, consecutively admitted in three Italian hospitals with a diagnosis of fragility hip fracture were included. Patients with periprosthetic or pathological fractures were excluded. Multivariate analysis was used to determine variables that significantly increased the risk of one-year mortality and Receiver operating characteristic (ROC) curve analysis to assess their predictive capacity on the outcome.1083 patients fulfilled the inclusion criteria and the one-year follow-up was reached in 728 patients. The 16.6% of patients died within one-year after surgery. At the multivariate analysis, advancing age (OR = 1.094, 95% CI = 1.057–1.132), higher baseline Charlson Index (OR = 1.257, 95% CI = 1.114–1.418) and Activities of Daily Living scores (OR = 1.259, 95% CI = 1.143–1.388), presence of hospital-acquired pressure ulcers (PUs) (OR = 1.579, 95% CI = 1.002–2.489) and lack recovery of ambulation (OR = 1.736, 95% CI = 1.115–2.703), were found to be independent predictive factors of one-year mortality after surgery. The area under the ROC curve of the model was 0.780 (CI95% 0.737–0.824) for one-year mortality in elderly hip fractures patients. Early ambulation and careful long-term follow-up, with attention to frailty in elderly people, should be promoted.

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Risk factors associated with treatment of hyperactive postoperative delirium in elderly patients following hip fracture surgery under regional anesthesia: a nationwide population-based study

Brazilian Journal of Anesthesiology (English Edition) ◽

10.1016/j.bjane.2021.03.020 ◽

2021 ◽

Author(s):

Eun-Jin Ahn ◽

Si Ra Bang

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Elderly Patients ◽

Regional Anesthesia ◽

Postoperative Delirium ◽

Population Based ◽

Population Based Study ◽

Factors Associated ◽

Hip Fracture Surgery ◽

Fracture Surgery

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THU0254 Risk factors for back pain in a cross sectional and in a one-year follow up study in nurses

10.1136/annrheumdis-2001.798 ◽

2001 ◽

Author(s):

M Brzosko ◽

I Fiedorowicz-Fabrycy ◽

J Fliciñski ◽

H Przepiera-Bêdzak ◽

K Prajs

Keyword(s):

Risk Factors ◽

Back Pain ◽

Cross Sectional ◽

Follow Up Study ◽

One Year

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Preoperative risk factors for postoperative blood transfusion after hip fracture surgery: establishment of a nomogram

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02557-5 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Fu Cheng Bian ◽

Xiao Kang Cheng ◽

Yong Sheng An

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Hip Fracture ◽

Blood Transfusion ◽

Multivariate Logistic Regression ◽

Preoperative Risk ◽

Hip Fracture Surgery ◽

Preoperative Risk Factors ◽

Independent Risk Factors ◽

Fracture Surgery

Abstract Background This study aimed to explore the preoperative risk factors related to blood transfusion after hip fracture operations and to establish a nomogram prediction model. The application of this model will likely reduce unnecessary transfusions and avoid wasting blood products. Methods This was a retrospective analysis of all patients undergoing hip fracture surgery from January 2013 to January 2020. Univariate and multivariate logistic regression analyses were used to evaluate the association between preoperative risk factors and blood transfusion after hip fracture operations. Finally, the risk factors obtained from the multivariate regression analysis were used to establish the nomogram model. The validation of the nomogram was assessed by the concordance index (C-index), the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curves. Results A total of 820 patients were included in the present study for evaluation. Multivariate logistic regression analysis demonstrated that low preoperative hemoglobin (Hb), general anesthesia (GA), non-use of tranexamic acid (TXA), and older age were independent risk factors for blood transfusion after hip fracture operation. The C-index of this model was 0.86 (95% CI, 0.83–0.89). Internal validation proved the nomogram model’s adequacy and accuracy, and the results showed that the predicted value agreed well with the actual values. Conclusions A nomogram model was developed based on independent risk factors for blood transfusion after hip fracture surgery. Preoperative intervention can effectively reduce the incidence of blood transfusion after hip fracture operations.

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Four or Twelve Months' Follow-Up in the Evaluation of Functional Outcome after Hip Fracture Surgery?

Scandinavian Journal of Surgery ◽

10.1177/145749690509400115 ◽

2005 ◽

Vol 94 (1) ◽

pp. 59-66 ◽

Cited By ~ 23

Author(s):

T. Heikkinen ◽

P. Jalovaara

Keyword(s):

Hip Fracture ◽

Repeated Measures ◽

The Elderly ◽

Important Variable ◽

Walking Ability ◽

Hip Fracture Surgery ◽

Age Related ◽

Walking Aids ◽

One Year

Background and Aims: As a rule, follow-up for at least one year is recommended for fracture studies. This is considered the shortest reliable interval. Still, in the case of hip fractures of the elderly, shorter follow-up might be more practical, since the life expectancy of these patients is often short. The aim of this study was to see if a short four months follow-up period would be acceptable in hip fracture surveys. Material and Methods: Information on 196 consecutive non-pathological hip fracture patients aged 50 years or over (mean 79 years) was collected using a standardised hip fracture audit concentrating on functional measurements at admission and at four and twelve months' follow-ups. Results: 167 patients were alive at four months and 152 and at one year. The patients who died between four and twelve months had poorer functional capacity in the four-month evaluation than those who survived one year. The analysis of repeated measures, including only the patients alive at the last follow-up, showed that residential status, use of walking aids and 6 out of 10 and ADL variables (bathing, toileting, shopping, household activities, doing laundry, banking) did not change significantly. Walking ability and the rest 4 ADL variables (dressing, eating, food preparation, use of transportation) improved and pain decreased. Conclusions: Due to high mortality and age-related deterioration of functioning, no steady state i.e. “final result” is ever reached after hip fracture in the elderly. Four-month follow-up is justified as the shortest possible period, because the socioeconomically most important variable, i.e. place of living, and most of the ADL functions do not change significantly after that.

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Weight loss with very-low-calorie diet and cardiovascular risk factors in moderately obese women: One-year follow-up study including ambulatory blood pressure monitoring

International Journal of Obesity ◽

10.1038/sj.ijo.0800644 ◽

1998 ◽

Vol 22 (7) ◽

pp. 661-666 ◽

Cited By ~ 16

Author(s):

T Pekkarinen ◽

I Takala ◽

P Mustajoki

Keyword(s):

Risk Factors ◽

Blood Pressure Monitoring ◽

Obese Women ◽

Pressure Monitoring ◽

Very Low Calorie Diet ◽

Follow Up Study ◽

Low Calorie Diet ◽

Calorie Diet ◽

One Year

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Risk factors associated with outcomes of hip fracture surgery in elderly patients

Korean Journal of Anesthesiology ◽

10.4097/kjae.2015.68.6.561 ◽

2015 ◽

Vol 68 (6) ◽

pp. 561 ◽

Cited By ~ 11

Author(s):

Byung Hoon Kim ◽

Sangseok Lee ◽

Byunghoon Yoo ◽

Woo Yong Lee ◽

Yunhee Lim ◽

...

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Elderly Patients ◽

Factors Associated ◽

Hip Fracture Surgery ◽

Fracture Surgery ◽

Surgery In Elderly

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

10.21203/rs.2.12969/v1 ◽

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.

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