scholarly journals Delirium Risk Factors in Elderly Patients Suffering from Femoral Neck Fractures

2018 ◽  
Vol 35 (1) ◽  
pp. 49-57
Author(s):  
Ivana Milićević ◽  
Slobodan Janković ◽  
Iva Grubor
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Case Control Study ◽  
Femoral Neck Fractures ◽  
Common Complication ◽  
Precipitating Factors ◽  
Hospitalized Elderly ◽  
Hospitalized Elderly Patients ◽  
Control Study

Summary Delirium is a common complication in hospitalized elderly patients suffering from hip fractures. Considering the growing incidence of delirium, understanding the risk factors for this condition is of great importance. The preoperative prevalence of delirium is approximately 4.4–35.6%, while postoperative prevalence is even higher - 4–53.3%. Various studies have shown the multifactorial etiology of delirium arising from a combination of predisposing and precipitating factors. The aim of this study was to explore these factors, which can contribute to delirium in patients with femoral neck fractures. This case control study included 62 patients diagnosed with femoral neck fractures, with 31 cases and 31 controls. Results have shown that the use of sedatives, especially benzodiazepines, and smoking increase the risk of delirium by five and sixteen times, respectively.

scholarly journals Risk factors for and predictive nomogram of postoperative hypoxaemia in elderly patients with femoral neck fractures

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052094513
Author(s):  
Xu-zhou Duan ◽  
Xin Zhang ◽  
Da-ke Tong ◽  
Fang Ji ◽  
Kai-hang Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Surgical Procedure ◽  
Bootstrap Method ◽  
Oxygenation Index ◽  
Femoral Neck Fractures ◽  
Asa Classification ◽  
Prediction Curve ◽  
The Bootstrap Method

Objective To investigate the related risk factors and predictive nomogram of postoperative hypoxaemia in elderly patients with femoral neck fractures. Methods This study included patients aged ≥65 years who underwent surgical treatment of acute femoral neck fractures. Univariate and multivariate logistic analyses were performed to determine the incidence of and risk factors for postoperative hypoxaemia. A predictive nomogram was constructed based on the multivariable model. Using the bootstrap method, discrimination was determined by the C-index and calibration plot. Results The logistic regression analysis showed that the anaesthesia type, surgical procedure, American Society of Anesthesiologists (ASA) classification, preoperative hypoxaemia occurrence, and age were independent predictors of development of postoperative hypoxaemia. The predictive formula for hypoxaemia was established as follows: hypoxaemia=−0.8668×spinal anaesthesia (whether)+0.1162×nerve anaesthesia (whether)+1.9555×plate/screw fixation (whether)+1.4950×hip replacement (whether)+0.4883×ASA classification+1.7153×preoperative oxygenation index+0.1608×age. With the bootstrap method, the prediction curve fit well with the ideal curve, suggesting that the prediction curve constructed in this study has good predictive ability. Conclusions Anaesthesia type, surgical procedure, ASA classification, preoperative hypoxaemia occurrence, and age were risk factors for postoperative hypoxaemia in elderly patients with femoral neck fractures. The predictive nomogram was designed for preoperative assessment of the risk of postoperative hypoxaemia by calculating the risk score.

scholarly journals Developing a Scoring Model to Predict the Risk of Injurious Falls in Elderly Patients: A Retrospective Case-control Study in Multi-center Acute Hospitals

2019 ◽  
Author(s):  
Min Zhao ◽  
Shuguang Li ◽  
Yun Xu ◽  
Xiaoxia Su ◽  
Hong Jiang
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Elderly Patients ◽  
Case Control Study ◽  
Assessment Tool ◽  
Retrospective Case ◽  
Injurious Falls ◽  
High Risk Populations ◽  
Control Study ◽  
Falls In Elderly

Abstract Background Injurious falls seriously threaten the safety of elderly patients. The identification of risk factors to predict the probability of injurious falls is an important issue still needed to be solved urgently. We aimed to identify predictors and develop a nomogram as an appropriate assessment tool for distinguishing high-risk populations of injurious falls from older adults in acute settings.Methods A retrospective case-control study was conducted in three acute care hospitals in Shanghai, China. We included elderly patients with injurious falls from 2014 to 2018, and the control patients without falls randomly identified from the electronic medical records. A new nomogram was established based on risk factors and its discrimination and calibration were verified to confirm the accuracy of the prediction. And the cut-off value of risk stratification was determined to help medical staff identify the high-risk groups.Results 115 elderly patients with injurious falls and 230 controls were identified in our study. The history of fractures, orthostatic hypotension, function status, sedative-hypnotics and the level of serum albumin were independent risk factors for injurious falls in elderly patients. And the scoring nomogram showed an acceptable predicting performance of injurious falls (C-index: 0.865, 95%CI: 0.789-0.941; corrected C-index: 0.868, 95%CI: 0.852-0.884). The threshold was 153 points to distinguish the high-risk groups from the aging patients, with acceptable sensitivity (72.2%) and specificity (86.1%).Conclusions The established nomogram will allow for identifying the high-risk populations among elderly patients, providing a new assessment tool to forecast the individual risk of injurious falls.

scholarly journals Nomogram for predicting reoperation following internal fixation of nondisplaced femoral neck fractures in elderly patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jian Zhu ◽  
Hongzhi Hu ◽  
Xiangtian Deng ◽  
Yiran Zhang ◽  
Xiaodong Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Calibration Curve ◽  
Weight Bearing ◽  
Femoral Neck Fractures ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors

Abstract Objective We aimed to evaluate risk factors and develop a nomogram for reoperation after internal fixation of nondisplaced femoral neck fractures (FNFs) in elderly patients. Methods We conducted a retrospective study involving a total of 255 elderly patients who underwent closed reduction and internal fixation with cannulated screw system for nondisplaced FNFs between January 2016 and January 2019. We collected data on demographics, preoperative radiological parameters, surgery, serum biochemical markers, and postoperative rehabilitation. In addition, we performed univariate and multivariate logistic regression analyses to determine independent risk factors for reoperation, and then developed a nomogram to assess the risks of reoperation. Besides, discriminative ability, calibration, and clinical usefulness of the nomogram were evaluated using the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. We employed bootstrap method to validate the performance of the developed nomogram. Results Our analysis showed that among the 255 patients, 28 (11.0%) underwent reoperation due to osteonecrosis of the femoral head (14 cases), mechanical failure (8 cases) or nonunion (6 cases). All of the 28 patients underwent conversion surgery to arthroplasty. The multivariate logistic regression analysis demonstrated that preoperative posterior tilt angle ≥ 20°, Pauwel’s III type, younger patients, preoperative elevated levels of alkaline phosphatase (ALP), preoperative hypoalbuminemia, and early postoperative weight-bearing were independent risk factors for reoperation. In addition, the C-index and the bootstrap value of the developed nomogram was 0.850 (95% CI = 0.803–0.913) and 0.811, respectively. Besides, the calibration curve showed good consistency between the actual diagnosed reoperation and the predicted probability, while the DCA indicated that the nomogram was clinically valuable. Conclusions Our analysis showed we successfully developed and validated a nomogram for personalized prediction of reoperation after internal fixation of nondisplaced FNFs in elderly patients. This model would help in individualized evaluation of the need for reoperation and inform strategies aimed at eliminating the need for the reoperation.

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