Eveline de Haan, Gert R Roukema, Veronique AJIM van Rijckevorsel, Tjallingius M Kuijper, Louis de Jong
{"title":"Risk Factors for 30-Days Mortality After Proximal Femoral Fracture Surgery, a Cohort Study","authors":"Eveline de Haan, Gert R Roukema, Veronique AJIM van Rijckevorsel, Tjallingius M Kuijper, Louis de Jong","doi":"10.2147/cia.s441280","DOIUrl":null,"url":null,"abstract":"<strong>Purpose:</strong> The primary objective of this study was to identify new risk factors and to confirm previously reported risk factors associated with 30-day mortality after hip fracture surgery.<br/><strong>Patients and methods:</strong> A prospective hip fracture database was used to obtain data. In total, 3523 patients who underwent hip fracture surgery between 2011 and 2021 were included. Univariable and multivariable logistic regression was used to screen and identify candidate risk factors. Twenty-seven baseline factors and 16 peri-operative factors were included in the univariable analysis and 28 of those factors were included in multivariable analysis.<br/><strong>Results:</strong> 8.6% of the patients who underwent hip fracture surgery died within 30 days after surgery. Prognostic factors associated with 30-day mortality after hip fracture surgery were as follows: age 90– 100 years (OR = 4.7, 95% CI: 1.07– 19.98, p = 0.041) and above 100 years (OR = 11.3, 95% CI: 1.28– 100.26, p = 0.029), male gender (OR = 2.6, 95% CI: 1.97– 3.33, p < 0.001), American Society of Anesthesiologists (ASA) 3 and ASA 4 (OR = 2.1, 95% CI: 1.44– 3.14, p < 0.001), medical history of dementia (OR = 1.7, 95% CI: 1.25– 2.36, p = 0.001), decreased albumin level (OR = 0.94, 95% CI: 0.92– 0.97, p < 0.001), decreased glomerular filtration rate (GFR) (OR = 0.98, 95% CI: 0.98– 0.99, p < 0.001), residential status of nursing home (OR = 2.1, 95% CI: 1.44– 2.87, p < 0.001), higher Katz Index of Independence in Activities of Daily Living (KATZ-ADL) score (OR = 1.1, 95% CI: 1.01– 1.16, p=0.018) and postoperative pneumonia (OR = 2.4, 95% CI: 1.72– 3.38, p < 0.001).<br/><strong>Conclusion:</strong> A high mortality rate in patients after acute hip fracture surgery is known. Factors that are associated with an increased mortality are age above 90 years, male gender, ASA 3 and ASA 4, medical history of dementia, decreased albumin, decreased GFR, residential status of nursing home, higher KATZ-ADL score and postoperative pneumonia.<br/><br/><strong>Keywords:</strong> hip fracture, mortality, independent risk factors, clinical outcomes<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"86 1","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Interventions in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/cia.s441280","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The primary objective of this study was to identify new risk factors and to confirm previously reported risk factors associated with 30-day mortality after hip fracture surgery. Patients and methods: A prospective hip fracture database was used to obtain data. In total, 3523 patients who underwent hip fracture surgery between 2011 and 2021 were included. Univariable and multivariable logistic regression was used to screen and identify candidate risk factors. Twenty-seven baseline factors and 16 peri-operative factors were included in the univariable analysis and 28 of those factors were included in multivariable analysis. Results: 8.6% of the patients who underwent hip fracture surgery died within 30 days after surgery. Prognostic factors associated with 30-day mortality after hip fracture surgery were as follows: age 90– 100 years (OR = 4.7, 95% CI: 1.07– 19.98, p = 0.041) and above 100 years (OR = 11.3, 95% CI: 1.28– 100.26, p = 0.029), male gender (OR = 2.6, 95% CI: 1.97– 3.33, p < 0.001), American Society of Anesthesiologists (ASA) 3 and ASA 4 (OR = 2.1, 95% CI: 1.44– 3.14, p < 0.001), medical history of dementia (OR = 1.7, 95% CI: 1.25– 2.36, p = 0.001), decreased albumin level (OR = 0.94, 95% CI: 0.92– 0.97, p < 0.001), decreased glomerular filtration rate (GFR) (OR = 0.98, 95% CI: 0.98– 0.99, p < 0.001), residential status of nursing home (OR = 2.1, 95% CI: 1.44– 2.87, p < 0.001), higher Katz Index of Independence in Activities of Daily Living (KATZ-ADL) score (OR = 1.1, 95% CI: 1.01– 1.16, p=0.018) and postoperative pneumonia (OR = 2.4, 95% CI: 1.72– 3.38, p < 0.001). Conclusion: A high mortality rate in patients after acute hip fracture surgery is known. Factors that are associated with an increased mortality are age above 90 years, male gender, ASA 3 and ASA 4, medical history of dementia, decreased albumin, decreased GFR, residential status of nursing home, higher KATZ-ADL score and postoperative pneumonia.
Keywords: hip fracture, mortality, independent risk factors, clinical outcomes
期刊介绍:
Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.