Risk Factors of Serious Adverse Events for Geriatric Hip Fractures: Is It the Frailty or the Timing?

Overview

Journal Geriatr Orthop Surg Rehabil

Publisher Sage Publications

Specialty Geriatrics

Date 2024 Apr 29

PMID 38681064

Authors

Ling-Xiao Wang

Li-Juan Guan

Ming-Hong Deng

Li-Hua Zhou

Affiliations

Soon will be listed here.

Abstract

Objective: Preoperative frailty and surgical waiting times are associated with the occurrence of adverse outcomes in patients with hip fractures. Specifically, we aimed to investigate the influence of frailty status and surgical timing on the risk of serious adverse events during hospitalization.

Methods: This study utilized an observational single cohort design and included patients aged ≥60 years with a primary diagnosis of hip fracture. Frailty was assessed using the chart-derived frailty index (CFI), which was calculated based on demographic and routine laboratory variables. The primary outcome of interest was the occurrence of in-hospital serious adverse events. A multivariate logistic regression model was utilized to examine the risk factors influencing outcomes.

Results: The study included 427 participants, with a mean age of 80.28 ± 8.13 years and 64.2% of whom were female. Patients with high CFI have more comorbidities ( < .001), lower surgical rates ( = .002), and delayed surgical times ( = .033). A total of 239 patients (56.0%) experienced serious adverse events. The high CFI group had a significantly higher occurrence of serious adverse events compared to the low CFI group (73.4% vs 48.5%, < .001). After adjusting for surgical timing and covariates, the multivariate logistic regression analysis revealed that high frailty significantly increased the risk for serious adverse events (OR = 2.47, 95% CI 1.398-4.412), infection (OR = 1.99, 95% CI 1.146-3.446), acute heart failure (OR = 3.37, 95% CI 1.607-7.045). However, the timing of surgery did not demonstrate any association with these outcomes. In addition, after adjusting for surgical factors, high CFI remains an independent risk factor for these complications.

Conclusions: Frailty serves as a reliable predictor of the probability of encountering severe adverse events while hospitalized for elderly individuals with hip fractures. This method has the potential to pinpoint particular modifiable factors that necessitate intervention, whereas the impact of surgical timing remains uncertain and necessitates additional research.

Citing Articles

Factors associated with thirty-day mortality and intensive care unit admission in patients undergoing hip fracture surgery.

Tekir Yilmaz E, Sahin Y, Olgun Keles B, Altinbas A Ulus Travma Acil Cerrahi Derg. 2024; 30(8):571-578.

PMID: 39092971 PMC: 11372486. DOI: 10.14744/tjtes.2024.24186.

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