scholarly journals Dialysis Dependence Is Associated With Significantly Increased Odds of Perioperative Adverse Events After Geriatric Hip Fracture Surgery Even After Controlling for Demographic Factors and Comorbidities

2019 ◽  
Vol 3 (8) ◽  
pp. e086 ◽  
Author(s):  
Taylor D. Ottesen ◽  
Alp Yurter ◽  
Blake N. Shultz ◽  
Anoop R. Galivanche ◽  
Cheryl K. Zogg ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Adverse Events ◽  
Demographic Factors ◽  
Hip Fracture Surgery ◽  
Geriatric Hip Fracture ◽  
Fracture Surgery

scholarly journals Factors affecting the incidence of surgical site infection after geriatric hip fracture surgery: a retrospective multicenter study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xiaopo Liu ◽  
Zhijie Dong ◽  
Jun Li ◽  
Yunbo Feng ◽  
Guolong Cao ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Surgical Site Infection ◽  
Multicenter Study ◽  
Geriatric Patients ◽  
Operating Time ◽  
Site Infection ◽  
Hip Fracture Surgery ◽  
Geriatric Hip Fracture ◽  
Fracture Surgery ◽  
Retrospective Multicenter Study

Abstract Background Geriatric hip fracture is a common type of osteoporotic fracture with high mortality and disability; surgical site infection (SSI) can be a devastating complication of this injury. By far, only a few studies identified easily remediable factors to reduce infection rates following hip fracture and less researches have focused on geriatric patients. The objective of this study was to identify potentially modifiable factors associated with SSI following geriatric hip fracture surgery. Methods This retrospective, multicenter study involves three level I hospitals. A total of 1240 patients (60 years or older) underwent hip surgery with complete data were recruited between January 2016 and June 2018. Demographics information, medications and additional comorbidities, operation-related variables, and laboratory indexes were extracted and analyzed. Receiver operating characteristic (ROC) analysis was performed to detect the optimum cut-off value for quantitative data. Univariate and multivariate logistic analysis model were performed respectively to identify the independent predictors. Results Ninety-four (7.58%) patients developed SSI in this study, and 76 (6.13%) had superficial infection, while 18 (1.45%) were diagnosed with deep infection. Results of univariate and multivariate analysis showed age > 79 years (OR, 2.60; p < 0.001), BMI > 26.6 kg/m2 (OR, 2.97; p < 0.001), operating time > 107 min (OR, 2.18; p = 0.001), and ALB < 41.6 g/L (OR, 2.01; p = 0.005) were associated with an increased incidence of SSI; drainage use (OR, 0.57; p = 0.007) could reduce the incidence of wound infection for patients after geriatric hip fracture. Conclusion Accurate modifiable variables, operating time > 107 min, serum albumin < 41.6 g/L, BMI > 26.6 kg/m2, and age > 79 years could be applied to distinguish geriatric patients with high-risk of postoperative surgical site infection.

scholarly journals The Rothman Index Is Associated With Postdischarge Adverse Events After Hip Fracture Surgery in Geriatric Patients

2018 ◽  
Vol 476 (5) ◽  
pp. 997-1006 ◽  
Author(s):  
Ryan P. McLynn ◽  
Taylor D. Ottesen ◽  
Nathaniel T. Ondeck ◽  
Jonathan J. Cui ◽  
Lee E. Rubin ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Adverse Events ◽  
Geriatric Patients ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Blood transfusion rates and predictors following geriatric hip fracture surgery

2020 ◽  
pp. 112070001989787 ◽  
Author(s):  
Armin Arshi ◽  
Wilson C Lai ◽  
Brenda C Iglesias ◽  
Edward J McPherson ◽  
Erik N Zeegen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Blood Transfusion ◽  
Hip Fractures ◽  
Improvement Program ◽  
Hip Fracture Surgery ◽  
Femur Fractures ◽  
Postoperative Blood Transfusion ◽  
Geriatric Hip Fracture ◽  
Fracture Surgery

Background: Postoperative blood product transfusions in elderly hip fracture patients cause concern for morbidity and mortality. The purpose of this study was to identify predictors and short-term sequelae of postoperative transfusion following geriatric hip fracture surgery. Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to identify geriatric (⩾65 years) patients who sustained operative femoral neck, intertrochanteric, and subtrochanteric hip fractures in 2016. Multivariate regression was used to determine risk-adjusted odds ratios (OR) of associated perioperative risk factors and sequelae of postoperative transfusion. Results: In total, 8416 geriatric hip fracture patients were identified of whom 28.3% had documented postoperative transfusion. In multivariate analysis, age (OR 1.03 [1.02–1.04], p < 0.001), preoperative anaemia (OR 4.69 [3.99–5.52], p = 0.001), female sex (OR 1.61 [1.39–1.87], p < 0.001), lower BMI (OR 0.97 [0.96–0.98], p < 0.001), American Society of Anesthesiologists (ASA) classification (OR 1.14 [1.01–1.27], p = 0.031), COPD (OR 1.30 [1.06–1.59], p = 0.011), hypertension (OR 1.17 [1.01–1.35], p = 0.038), increased OR time (OR 1.02 [1.01–1.03], p < 0.001), and intertrochanteric (OR 2.99 [2.57–3.49], p < 0.001) and subtrochanteric femur fractures (OR 5.07 [3.84–6.69], p < 0.001) were independent risk factors for receiving postoperative blood transfusion. Patients with postoperative transfusion had a significantly higher risk-adjusted 30-day mortality (8.4% vs. 6.4%, OR 1.29 [1.02–1.64], p = 0.035), hospital readmission rate (9.4% vs. 7.7%, OR 1.27 [1.04–1.55], p = 0.018), and total hospital LOS (7.3 vs. 6.3 days, p < 0.001). Conclusions: Postoperative transfusion is a common occurrence in geriatric fragility hip fractures with multiple risk factors. Careful preoperative planning and multidisciplinary management efforts are warranted to reduce use of postoperative transfusions.

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