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Risk factors for postoperative mortality at 30 days in elderly Chinese patients with hip fractures

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Abstract

Summary

Arrhythmia, pneumonia, cardiac insufficiency, a high leukocyte count, and low albumin concentrations were associated with increased 30-day mortality in elderly hip fracture patients after surgery. It is important to improve short-term survival rates by optimizing the respiratory and cardiac function of geriatric patients before they undergo surgery.

Introduction

This study aims to investigate the 30-day mortality and related risk factors for elderly patients following surgery for hip fractures.

Methods

This retrospective study examined chart reviews for evaluating associations of gender, age, fracture site, biochemical indicators, pre-surgery comorbidities, number of pre-surgery comorbidities, time to surgery and anesthesia and surgery methods with postoperative 30-day mortality in elderly hip fracture surgery patients.

Results

A total of 1,004 patients were included in the study and 43 (4.3%) patients died within 30 days after surgery. Univariate analysis showed that patients in the non-survival group had a higher mean age, higher leukocyte counts, lower hemoglobin and albumin levels, a higher proportion of arrhythmias, pneumoniae and cardiac insufficiency and number of presurgical comorbidities than the survival group (all P-values < 0.05). Multivariate logistic analysis further confirmed that arrhythmia (OR = 2.033, P = 0.038), pneumonia (OR = 2.246, P = 0.041), cardiac insufficiency (OR = 2.833, P = 0.029), high leukocyte count (OR = 1.139, P = 0.009), and low albumin (OR = 0.925, P = 0.041) were all significant risk factors for mortality 30 days after surgery.

Conclusions

This study demonstrates that arrhythmia, pneumonia, cardiac insufficiency, a high leukocyte count, and low albumin concentrations were associated with increased 30-day mortality in elderly hip fracture patients after surgery.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

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Authors and Affiliations

  1. Department of Orthopaedics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China

    X. Chen

  2. Department of Orthopaedics, The Seventh Medical Center, Chinese PLA General Hospital, No. 5 Nanmencang, Beijing, 100700, China

    X. Chen, J. Zhang, Y. Lin, Z. Liu, T. Sun & X. Wang

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Correspondence to X. Wang.

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The protocol for this study was approved by the Institutional Ethics Committee of Chinese PLA General Hospital (No. 201708166).

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Chen, X., Zhang, J., Lin, Y. et al. Risk factors for postoperative mortality at 30 days in elderly Chinese patients with hip fractures. Osteoporos Int 33, 1109–1116 (2022). https://doi.org/10.1007/s00198-021-06257-y

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