scholarly journals Effects of Anticoagulants on Outcome of Femoral Neck Fracture Surgery

2015 ◽  
Vol 23 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Bastiaan L Ginsel ◽  
Ahmad Taher ◽  
Sarah L Whitehouse ◽  
Jack J Bell ◽  
Chrys R Pulle ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Neck Fracture ◽  
Fracture Surgery

scholarly journals Effect of nutritional status before femoral neck fracture surgery on postoperative outcomes: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Katsuya Yokoyama ◽  
Taku Ukai ◽  
Masahiko Watanabe
Keyword(s):  
Femoral Neck ◽  
Nutritional Status ◽  
Femoral Neck Fracture ◽  
Transfer Rate ◽  
Normal Group ◽  
Postoperative Outcomes ◽  
Transfusion Rate ◽  
Neck Fracture ◽  
Gait Function ◽  
Fracture Surgery

Abstract Background Although nutritional status is crucial in gait recovery after femoral neck fracture surgery, the relationship between preoperative nutritional status and postoperative outcomes remains unknown. This study examined the effects of preoperative nutritional status on postoperative outcomes in patients undergoing femoral neck fracture surgery. Methods Data regarding the joints of 137 patients (29 men, 108 women) who underwent bipolar hemiarthroplasty for femoral neck fractures at our hospital from January 2015 to December 2019 were retrospectively examined. The Geriatric Nutritional Risk Index (GNRI), an index of nutritional status, was used to classify patients into two groups: a normal group (GNRI ≥92; n = 62) and an undernourished group (GNRI < 92; n = 75). The study endpoints included age at surgery, sex, Mini Mental State Examination (MMSE), American Society of Anesthesiologists Physical Status (ASA) classification, preoperative waiting period, intraoperative blood loss, surgery time, perioperative hemoglobin levels, blood transfusion rate, complication rate, 6-month mortality rate, transfer rate, percentage of patients unable to walk at discharge or transfer, and inability to walk 6 months postoperatively. Results The patients in the undernourished group was significantly older at surgery (p < 0.01) and had a lower perioperative hemoglobin levels (p < 0.01), a higher blood transfusion rate (p < 0.01), a lower MMSE (p < 0.01), a longer preoperative waiting period (p < 0.05), a higher transfer rate (p < 0.05), were more likely to be unable to walk 6 months postoperatively (p < 0.01), a higher complication rate (p < 0.05), and a higher 6-month mortality rate (p < 0.01) than the normal group. Patients in the undernourished group had worse rates of postoperative complications, transfer, mortality, and inability to walk 6-month after surgery than those in the normal group. Conclusions A poor nutritional status affects the gait function and systemic condition of patients undergoing femoral neck fracture surgery; therefore, early nutritional interventions may reduce mortality rates and shorten rehabilitation. These results suggest that the GNRI effectively predicts postoperative complications, mortality, and gait function.

Comparison of Routine Prophylaxis With Vancomycin or Cefazolin for Femoral Neck Fracture Surgery: Microbiological and Clinical Outcomes

2006 ◽  
Vol 27 (12) ◽  
pp. 1366-1371 ◽  
Author(s):  
Jacques Merrer ◽  
Laetitia Desbouchages ◽  
Valérie Serazin ◽  
Jimmy Razafimamonjy ◽  
François Pauthier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Routine Prophylaxis ◽  
Neck Fracture ◽  
Vancomycin Resistant ◽  
Group 2 ◽  
Vancomycin Group ◽  
The Impact ◽  
Fracture Surgery

Objective.To assess the impact of antibiotic prophylaxis on the emergence of vancomycin-resistant strains ofEnterococcus faecium, Enterococcus faecalis, andStaphylococcus aureusand the incidence of surgical site infection (SSI) after vancomycin or cefazolin prophylaxis for femoral neck fracture surgery.Design.Prospective cohort study.Setting.A hospital with a high prevalence of methicillin-resistantS. aureus(MRSA) carriage.Patients.All patients admitted with a femoral neck fracture from March 1, 2004 through February 28, 2005 were prospectively identified and screened for MRSA and vancomycin-resistant (VRE) carriage at admission and at day 7. Deep incisional and organ/space SSIs were also recorded.Results.Of 263 patients included in the study, 152 (58%) received cefazolin and 106 (40%) received vancomycin. At admission, the prevalence of MRSA carriage was 6.8%; it was 12% among patients with risk factors and 2.2% among patients with no risk factors (P= .002). At day 7 after surgery, there were 6 patients (2%) who had hospital-acquired MRSA, corresponding to 0.7% in the cefazolin group and 5% in the vancomycin group (P= .04); none of the MRSA isolates were resistant to glycopeptides. The rate of VRE carriage at admission was 0.4%. Three patients (1%) had acquired carriage of VRE (1 hadE. faeciumand 2 hadE. faecalis); all 3 were in the cefazolin group (2% of patients) and none in the vancomycin group (P= .27). Eight SSIs (3%) occurred, 4% in the cefazolin group and 2% in the vancomycin group (P= .47).Conclusions.This preliminary study demonstrates that cefazolin and vancomycin prophylaxis have similar impacts on the emergence of glycopeptide-resistant pathogens. Neither MRSA infection nor increased rates of SSI with other bacteria were observed in the vancomycin group, suggesting that a larger multicenter study should be initiated.

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