In-hospital complications in elderly patients with hip fracture: cross-sectional study to determine the associated factors
DOI:
https://doi.org/10.1016/j.rccot.2019.02.004Keywords:
hip fracture, orthogeriatrics, elderlyAbstract
Background: This study aims to determine the factors associated with the presence of inhospital complications in elderly patients with hip fracture.
Methods: A retrospective, observational study of patients older than 65 years admitted to the San Ignacio University Hospital (Bogotá, Colombia) with hip fracture in the period between January 2013 and December 2015. A review of the clinical history of each patient was carried out by extracting demographic data, disease history, geriatric syndromes, status on admission, date of the surgical procedure, and the presence of complications. A multivariate analysis was subsequently performed in order to determine the risk factors associated with the presence of in-hospital complications.
Results: An analysis was carried out on the data collected from 141 patients. The mean age was 80.3 years (SD 7.86), with 62.4% of the sample being women, and the mean hospital stay was 7.89 days (SD 5.65). The three most frequent geriatric conditions were malnutrition, polypharmacy, and falls, Just over half (53%) of the patients were independent for basic activities of daily living (Barthel> 90). During the hospital stay, 54.6% of the sample had some complication. Mortality in the hospital period was 9.9%.
Discussion: Functional dependence, increased anaesthetic risk, supplementary oxygen requirement during the post-operative period, and length of hospital stay were independent factors for the presence of in-hospital complications.
Evidence Level: III.
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References
Wolinsky FD, Fitzgerald JF, Stump TE. The effect of HIP fracture on mortality, hospitalization, and functional status: A prospective study. Am J Public Health. 1997;87:398-403. https://doi.org/10.2105/AJPH.87.3.398
Alarcón T, González-Montalvo JI. Fractura de cadera en el paciente mayor. Rev Esp Geriatr Gerontol [Internet]. 2010;45:167-70. https://doi.org/10.1016/j.regg.2009.12.003
Cassim B, Lipschitz S, Paruk FBT. Recommendations for the acute and long-term medical management of low-trauma hip fractures. J Endocrinol Metab Diabetes South Africa [Internet]. 2013;18:21-32. https://www.semanticscholar.org/paper/Recommendations-for-the-acute-and-long-term-medical-Cassim-Lipschitz/a9f014c7103a6bd5191901b9d57081c8cb053e3b. https://doi.org/10.1080/22201009.2013.10872302
Prestmo A, Saltvedt I, Helbostad JL, Taraldsen K, Thingstad P, Lydersen S, et al. Who benefits from orthogeriatric treatment? Results from the Trondheim hip-fracture trial. BMC Geriatr. 2016;16:49. https://doi.org/10.1186/s12877-016-0218-1
González-Montalvo JI, Maulen JL, Gil-Garay E, Gotor P, MartínVega A. The orthogeriatric unit for acute patients: A new model of care that improves efficiency in the management of patients with hip fracture. HIP Int. 2010;20:229-35. https://doi.org/10.1177/112070001002000214
Ginsberg G, Adunsky A, Rasooly I. A cost-utility analysis of a comprehensive orthogeriatric care for hip fracture patients, compared with standard of care treatment. HIP Int. 2013;23:570-5. https://doi.org/10.5301/hipint.5000080
Dovjak P, Iglseder B, Mikosch P, Gosch M, Müller E, Pinter G, et al. Treatment and prevention of postoperative complications in hip fracture patients?: infections and delirium. 2013:448-54. https://doi.org/10.1007/s10354-013-0228-y
Folbert EC, Hegeman JH, Vermeer M, Regtuijt EM, van der Velde D, Ten Duis HJ, et al. Complications during hospitalization and risk factors in elderly patients with hip fracture following integrated orthogeriatric treatment. Osteoporos Int. 2016:1-9. https://doi.org/10.1007/s00198-016-3711-7
Grigoryan KV, Javedan H, Rudolph JL. Orthogeriatric care models and outcomes in hip fracture patients: a systematic review and meta-analysis. J Orthop Trauma [Internet]. 2014;28:e49-55. https://pubmed.ncbi.nlm.nih.gov/23912859/.https://doi.org/10.1097/BOT.0b013e3182a5a045
González Montalvo JI, Alarcón Alarcón T, Pallardo Rodil B, Gotor Pérez P, Pareja Sierra T. Ortogeriatría en pacientes agudos (II). Aspectos clínicos. Rev Esp Geriatr Gerontol. 2008;43: 316-29. https://doi.org/10.1016/S0211-139X(08)73574-1
Ríos A, Herrera D, Ortega A, Aluma E. Morbilidad y mortalidad en pacientes mayores de 60 años con fractura de cadera en el Hospital Universitario San Vicente Fundación, de Medellín, Colombia. Iatreia. 2012;25:305-13. https://doi.org/10.17533/udea.iatreia.13104
Suarez S, Pesantez RF, Diaz ME, Sanchez D, Tristancho LJ, Vanegas MV, et al. Impact on Hip Fracture Mortality After the Establishment of an Orthogeriatric Care Program in a Colombian Hospital. J Aging Health. 2016. https://doi.org/10.1177/0898264316636839
Belmont PJ, Garcia EJ, Romano D, Bader JO, Nelson KJ, Schoenfeld AJ. Risk factors for complications and in-hospital mortality following hip fractures: A study using the National Trauma Data Bank. Arch Orthop Trauma Surg. 2014;134: 597-604. https://doi.org/10.1007/s00402-014-1959-y
Tsuda Y, Yasunaga H, Horiguchi H, Ogawa S, Kawano H, Tanaka S. Association between dementia and postoperative complications after hip fracture surgery in the elderly: analysis of 87,654 patients using a national administrative database. Arch Orthop Trauma Surg. 2015;135: 1511-7. https://doi.org/10.1007/s00402-015-2321-8
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