Risk Factors for Subsequent Contralateral Hip Fracture following Osteoporotic Hip 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.

Download Full-text

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

Download Full-text

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.

Download Full-text

The risk factors for postoperative delirium in adult patients after hip fracture surgery: a systematic review and meta‐analysis

International Journal of Geriatric Psychiatry ◽

10.1002/gps.5408 ◽

2020 ◽

Vol 36 (1) ◽

pp. 3-14

Author(s):

Juan Wu ◽

Yushuang Yin ◽

Man Jin ◽

Bixi Li

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Hip Fracture ◽

Postoperative Delirium ◽

Meta Analysis ◽

Adult Patients ◽

Hip Fracture Surgery ◽

Fracture Surgery

Download Full-text

Risk factors for insufficient perioperative oral nutrition after hip fracture surgery within a multi-modal rehabilitation programme

Age and Ageing ◽

10.1093/ageing/afm079 ◽

2007 ◽

Vol 36 (5) ◽

pp. 538-543 ◽

Cited By ~ 33

Author(s):

N. B. Foss ◽

P. S. Jensen ◽

H. Kehlet

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Rehabilitation Programme ◽

Oral Nutrition ◽

Hip Fracture Surgery ◽

Fracture Surgery

Download Full-text

Predictors of Acute Kidney Injury After Hip Fracture in Older Adults

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320920088 ◽

2020 ◽

Vol 11 ◽

pp. 215145932092008 ◽

Cited By ~ 3

Author(s):

Julie Braüner Christensen ◽

Martin Aasbrenn ◽

Luana Sandoval Castillo ◽

Anette Ekmann ◽

Thomas Giver Jensen ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Hip Fracture ◽

Blood Transfusion ◽

Multivariable Analysis ◽

Kidney Injury ◽

C Reactive Protein ◽

Hip Fracture Surgery ◽

Reactive Protein ◽

Fracture Surgery

Introduction: This study aimed to investigate the prevalence of acute kidney injury (AKI) following hip fracture surgery in geriatric patients and to identify predictors for development of AKI with a focus on possible preventable risk factors. Methods: In this retrospective cohort study, we reviewed electronic medical records of all patients above 65 years of age who underwent hip fracture surgery at Copenhagen University Hospital, Bispebjerg, Denmark, in 2018. Acute kidney injury was assessed according to the Kidney Disease Improving Global Outcomes guidelines. Multivariate logistic regression analyses were used to identify independent risk factors for AKI. Results: Postoperative AKI developed in 28.4% of the included patients (85/299). Acute kidney injury was associated with increased length of admission (11.3 vs 8.7 days, P < .001) and 30-day mortality (18/85 vs 16/214, P = .001). In multivariable analysis, higher age (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01-1.08, P = .004), heart disease (OR: 1.78, 95% CI: 1.01-3.11, P = .045), and postoperative blood transfusion (OR: 1.84, 95% CI: 1.01-3.36, P = .048) were associated with AKI. Moreover, a higher postoperative C-reactive protein (199.0 ± 99.9 in patients with AKI, 161.3 ± 75.2 in patients without AKI) and lower postoperative diastolic blood pressure were observed in patients developing AKI. Discussion and Conclusion: Acute kidney injury was common following hip fracture surgery and associated with longer admissions and increased mortality. Patients developing AKI were older and showed several postoperative similarities, including higher C-reactive protein, lower postoperative diastolic pressure, and the need for blood transfusion.

Download Full-text