ESRA19-0378 Poor autonomy and delirium are independent risk factors for major complications after hip-fracture in elderly: a retrospective analisys

2019 ◽  
Author(s):  
G Bolondi ◽  
A Maggi ◽  
F Bizzarri ◽  
G Cappelleri
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Major Complications ◽  
Independent Risk Factors

scholarly journals Preoperative risk factors for postoperative blood transfusion after hip fracture surgery: establishment of a nomogram

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fu Cheng Bian ◽  
Xiao Kang Cheng ◽  
Yong Sheng An
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Hip Fracture ◽  
Blood Transfusion ◽  
Multivariate Logistic Regression ◽  
Preoperative Risk ◽  
Hip Fracture Surgery ◽  
Preoperative Risk Factors ◽  
Independent Risk Factors ◽  
Fracture Surgery

Abstract Background This study aimed to explore the preoperative risk factors related to blood transfusion after hip fracture operations and to establish a nomogram prediction model. The application of this model will likely reduce unnecessary transfusions and avoid wasting blood products. Methods This was a retrospective analysis of all patients undergoing hip fracture surgery from January 2013 to January 2020. Univariate and multivariate logistic regression analyses were used to evaluate the association between preoperative risk factors and blood transfusion after hip fracture operations. Finally, the risk factors obtained from the multivariate regression analysis were used to establish the nomogram model. The validation of the nomogram was assessed by the concordance index (C-index), the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curves. Results A total of 820 patients were included in the present study for evaluation. Multivariate logistic regression analysis demonstrated that low preoperative hemoglobin (Hb), general anesthesia (GA), non-use of tranexamic acid (TXA), and older age were independent risk factors for blood transfusion after hip fracture operation. The C-index of this model was 0.86 (95% CI, 0.83–0.89). Internal validation proved the nomogram model’s adequacy and accuracy, and the results showed that the predicted value agreed well with the actual values. Conclusions A nomogram model was developed based on independent risk factors for blood transfusion after hip fracture surgery. Preoperative intervention can effectively reduce the incidence of blood transfusion after hip fracture operations.

scholarly journals Factors associated with 90-day acute ischemic stroke in patients ≥70 years old with total hip arthroplasty for hip fracture

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui He ◽  
Guoyou Wang ◽  
Ting Li ◽  
Huarui Shen ◽  
LijuanZhang
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Older Age ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background Postoperative ischemic stroke is a devastating complication following total hip arthroplasty (THA). The purpose of the current study was to investigate the incidence of postoperative acute ischemic stroke (AIS) in patients ≥70 years old with THA for hip fracture after 90 days and independent risk factors associated with 90-day AIS. Methods A multicenter retrospective study was conducted, patients ≥70 years old with THA for hip fracture under general anesthesia were included from February 2017 to March 2020. Patients with AIS within 90 days after THA were identified as AIS group; patients with no AIS were identified as no AIS group. The baseline characteristics and risk factors were collected, multivariable logistic regression was used to identify independent risk factors of 90-dayAIS. Results: 2517 patients (mean age 76.18 ± 6.01) were eligible for inclusion in the study. 2.50% (63/2517) of patients had 90-day AIS. Compared with no AIS, older age, diabetes, hyperlipidemia, atrial fibrillation (AF) and higher D-dimer value were more likely in patients with AIS (P < 0.05), and anticoagulant use was fewer in patients with AIS. ROC curve analysis showed that the optimal cut point of D-dimer for AIS was D-dimer≥4.12 μg/ml. Multivariate logistic regression analysis showed that D-dimer≥4.12 μg/ml [adjusted odds ratio (aOR), 4.44; confidence interval (CI), 2.50–7.72; P < 0.001], older age (aOR, 1.08; 95%CI, 1.03–1.12; P < 0.001), hyperlipidemia (aOR, 2.28; 95%CI, 1.25–4.16; P = 0.007), atrial fibrillation (aOR, 5.84; 95% CI, 1.08–15.68; P = 0.001), and diabetes (aOR, 2.60; 95% CI, 1.56–4.39; P < 0.001) were associated with increased risk of 90-day AIS after THA. Conclusions In conclusion, we found that the incidence of 90-day AIS in patients≥70 years old with THA for hip fracture was 2.5%. Older age, diabetes, hyperlipidemia, AF and higher D-dimer value were independent risk factors for 90-day AIS in patients≥70 years old with THA for hip fracture.

Incidence And Risk Factors For Postoperative Pneumonia Following Surgically Treated Hip Fracture In Geriatric Patients: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Yunxu Tian ◽  
Yanbin Zhu ◽  
Kexin Zhang ◽  
Miao Tian ◽  
Shuhui Qin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Geriatric Patients ◽  
Multivariate Analyses ◽  
Postoperative Pneumonia ◽  
Multivariate Logistic Regression Model ◽  
Preventive Strategy ◽  
Tertiary Referral Center ◽  
Independent Risk Factors ◽  
Clinical Conditions

Abstract Objective: Large sample investigations for risk factors for pneumonia in elderly patients after hip fracture surgeries are lacking. The purpose of this study is to determine the incidence and risk factors for postoperative pneumonia in geriatric patients following hip fracture operations.Methods: A retrospective study of incidence and risk factors in a tertiary referral center between 2016 and 2020 was conducted. Geriatric patients who developed postoperative pneumonia after surgeries of hip fracture during hospitalization stay were defined as cases and those without as controls. Multivariate logistic regression model was used to evaluate risk factors for postoperative pneumonia.Results: This study included 3147 patients, and 182 developed postoperative pneumonia, denoting the rate of 5.7%. In the multivariate analyses, age (OR, 1.04; 95% CI, 1.02–1.06), sex (males) (OR, 2.27; 95% CI, 1.64-3.13), respiratory disease (OR, 3.74; 95% CI, 2.32–6.04), heart disease (OR, 1.68; 95% CI, 1.14–2.47), cerebrovascular disease (OR, 1.58; 95% CI, 1.11–2.27), liver disease (OR, 2.61; 95% CI, 1.33–5.15), preoperative stay (OR, 1.08; 95% CI, 1.05–1.11) and general anesthesia (OR, 1.61; 95% CI, 1.15-2.27) were identified as independent risk factors for postoperative pneumonia.Conclusions: This study identified several risk factors for pneumonia in geriatric patients after hip fracture operations, providing a viable preventive strategy for optimizing clinical conditions for reductionof postoperative pneumonia.

scholarly journals Complication analysis in nitinol stent-assisted embolization of 486 intracranial aneurysms

2015 ◽  
Vol 123 (2) ◽  
pp. 453-459 ◽  
Author(s):  
Andrew Kelly Johnson ◽  
Stephan A. Munich ◽  
Lee A. Tan ◽  
Daniel Mark Heiferman ◽  
Kiffon Marie Keigher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Aneurysm ◽  
Intracranial Aneurysms ◽  
Giant Aneurysm ◽  
Neurological Complications ◽  
Complication Rates ◽  
Major Complications ◽  
Aneurysm Size ◽  
Aneurysm Treatment ◽  
Independent Risk Factors

OBJECT Stent-assisted embolization (SAE) has broadened the scope of endovascular cerebral aneurysm treatment. The risks associated with stent selection and configuration are poorly defined. In this study, the authors aimed to characterize the risk factors that contribute to complications in SAE of intracranial aneurysms. METHODS Over a 10-year period, a single surgeon treated 486 aneurysms with SAE in which open-cell Neuroform or closed-cell Enterprise stents were used. Single stents were used in 386 cases, overlapping stents were deployed in 80 cases, and Y-configuration stents were used in the remaining 20 cases. All neurological complications, which included transient deficits, were analyzed; disabling strokes and death were considered major complications. The chi-square test and multivariate logistic regression were used to evaluate the influence of aneurysm size and morphology, aneurysm location, stent selection, and stent configuration on complication rates. RESULTS There were 7 deaths (1.4%), 9 major strokes (1.9%), and 18 minor neurological complications (3.7%). For all complications, multivariate analysis revealed that large aneurysm size (10–25 mm; p = 0.01), giant aneurysm size (> 25 mm; p = 0.04), fusiform aneurysm morphology (p = 0.03), and using a Y-configuration stent (p = 0.048) were independent risk factors. For the major complications, independent risk factors included an aneurysm in the posterior circulation (p = 0.02), using an overlapping stent configuration (p = 0.03), and using a Y-configuration stent (p < 0.01). CONCLUSIONS In this series, SAE for cerebral aneurysm treatment carried an acceptable complication rate. With continued innovations in techniques and devices and with increased experience, the complication rates associated with SAE may be even lower in the future.

Albumin-Indocyanine Green Evaluation Grading System Predicts Post-Hepatectomy Liver Failure for Biliary Tract Cancer

2018 ◽  
Vol 36 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Yoshihiro Miyazaki ◽  
Takashi Kokudo ◽  
Katsumi Amikura ◽  
Amane Takahashi ◽  
Nobuhiro Ohkohchi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Failure ◽  
Indocyanine Green ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Preoperative Evaluation ◽  
Grading System ◽  
Tract Cancer ◽  
Major Complications ◽  
Independent Risk Factors

Background: In biliary tract cancer treatment, a precise preoperative evaluation of the patient’s liver function is essential to avoid post-hepatectomy liver failure (PHLF) and mortality. The present study aimed to evaluate the role of the Albumin-Indocyanine Green Evaluation (ALICE) grading system in predicting PHLF in biliary tract cancer patients. Methods: Data from 166 patients who underwent hepatectomy for biliary tract cancer between 2000 and 2016 were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the risk factors for PHLF. Results: Among the 166 patients, major hepatectomy was performed in 101 (61%) and bile duct resection was performed in 99 (60%) patients. Thirteen (8%) patients developed PHLF. Furthermore, PHLF, major complications, and mortality were significantly higher in patients with high ALICE grades (≥2b) than in those with low ALICE grades (<2b) (PHLF, 42 vs. 18%, p = 0.002; major complications, 35 vs. 19%, p = 0.036; mortality, 9.3 vs. 0%, p = 0.001). In multivariate analysis, high ALICE grade (p = 0.016) and blood loss ≥1,500 mL (p = 0.009) were identified as independent risk factors for PHLF. Conclusions: The ALICE grading system effectively stratified the risks for PHLF for biliary tract cancer.

Racial Differences in Bone Dependent and Bone Independent Risk Factors for Hip Fracture

2004 ◽  
Vol 36 (Supplement) ◽  
pp. S209
Author(s):  
Vicky C. Zachariadou ◽  
Kristine M. Ross ◽  
Ellen M. Evans ◽  
Karl S. Rosengren ◽  
Edward McAuley
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Racial Differences ◽  
Independent Risk Factors

Surgical treatment of hip fracture in centenarians: Complications and independent risk factors of death

Injury ◽  
2020 ◽  
Vol 51 ◽  
pp. S25-S29
Author(s):  
Irene Isabel López-Torres ◽  
Pablo Sanz-Ruiz ◽  
Nuria Montero-Fernández ◽  
Francisco Chana ◽  
Jose Antonio Serra-Rexach ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Hip Fracture ◽  
Independent Risk Factors

scholarly journals A simple scoring system for predicting early major complications in spine surgery: the cumulative effect of age and size of surgery

2016 ◽  
Vol 74 (10) ◽  
pp. 803-809 ◽  
Author(s):  
Albert Vincent Berthier Brasil ◽  
Alisson R. Teles ◽  
Marcelo Ricardo Roxo ◽  
Marcelo Neutzling Schuster ◽  
Eduardo Ballverdu Zauk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spine Surgery ◽  
Scoring System ◽  
Cumulative Effect ◽  
Patient Counseling ◽  
Factors Associated ◽  
Major Complications ◽  
Postoperative Spine ◽  
Independent Risk Factors ◽  
Effect Of Age

ABSTRACT Objective To analyze the cumulative effect of risk factors associated with early major complications in postoperative spine surgery. Methods Retrospective analysis of 583 surgically-treated patients. Early “major” complications were defined as those that may lead to permanent detrimental effects or require further significant intervention. A balanced risk score was built using multiple logistic regression. Results Ninety-two early major complications occurred in 76 patients (13%). Age > 60 years and surgery of three or more levels proved to be significant independent risk factors in the multivariate analysis. The balanced scoring system was defined as: 0 points (no risk factor), 2 points (1 factor) or 4 points (2 factors). The incidence of early major complications in each category was 7% (0 points), 15% (2 points) and 29% (4 points) respectively. Conclusions This balanced scoring system, based on two risk factors, represents an important tool for both surgical indication and for patient counseling before surgery.

scholarly journals Predictors of 30-day mortality in orthogeriatric fracture patients aged 85 years or above admitted from the emergency department

2019 ◽  
Author(s):  
Henk Jan Schuijt ◽  
Jelle Bos ◽  
Diederik Pieter Johan Smeeing ◽  
Olivia Geraghty ◽  
Detlef van der Velde
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hip Fracture ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Geriatric Fracture ◽  
Hip Fracture Surgery ◽  
Independent Risk Factors ◽  
Male Sex ◽  
Fracture Surgery

Abstract Purpose Orthogeriatric trauma patients are at risk for functional decline and mortality. It is important to identify high-risk patients in an early stage, to improve outcomes and make better informed treatment decisions. The aim of this study was to identify independent risk factors for 30-day mortality in patients aged 85 years or above admitted from the emergency department with a fracture. Methods All orthopaedic trauma patients 85 years or above admitted from the emergency department were included. After a 30-day follow-up, mortality was determined by consulting the patient records. Multivariable logistics regression analysis generated odd ratios for mortality risk factors. A subgroup analysis was performed for patients undergoing hip fracture surgery. Results The 30-day mortality in geriatric fracture patients admitted to the hospital was 12%. Risk factors for 30-day mortality were: increased age, male sex, decreased hemoglobin levels, living in an institutional care facility and a decreased BMI. For geriatric patients undergoing hip fracture surgery 30-day mortality was 11%. Independent risk factors for this group were: increased age, male sex, and a decreased BMI. Conclusion Orthopaedic trauma patients aged 85 years or above who are admitted to the hospital with a fracture are at high risk for mortality. This study identified older age, male sex, and decreased BMI as predictors of 30-day mortality in admitted geriatric fracture patients and in geriatric hip fracture patients undergoing surgery.

scholarly journals The risk factors of postoperative delirium in patients with hip fracture: implication for clinical management

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Weifang Xu ◽  
Haiping Ma ◽  
Wang Li ◽  
Chen Zhang
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Postoperative Delirium ◽  
Area Under The Curve ◽  
Hip Fracture Surgery ◽  
Related Risk ◽  
History Of ◽  
Laboratory Examinations ◽  
Independent Risk Factors ◽  
Epidemiological Characteristics

Abstract Background Delirium is a common complication of hip surgery patients. It is necessary to investigate the epidemiological characteristics and related risk factors of delirium after hip fracture surgery, to provide evidence supports for the prevention and management of delirium. Methods Hip fracture patients admitted to our hospital for surgical treatment from March 2018 to March 2020 were identified as participants. The characteristics and laboratory examinations in patients with and without postoperative delirium were compared and analyzed. Logistic regression analyses were conducted to ascertain the independent risk factors, and the area under the curve (AUC) were calculated to analyze the predictive value. Results A total of 568 postoperative patients with hip fracture were included, the incidence of delirium in postoperative patients with hip fracture was 14.44 %. The preoperative albumin (OR 4.382, 2.501 ~ 5.538), history of delirium (OR 2.197, 1.094 ~ 3.253), TSH (OR1.245, 1.077 ~ 1.638), the resting score on the first postoperative day (OR1.235, 0.944 ~ 1.506) and age(OR1.185, 0.065 ~ 1.814) were the independent risk factors for the postoperative delirium in patients with hip fracture(all p < 0.05). The AUC of albumin, history of delirium, TSH, the resting score on the first postoperative day and age were 0.794, 0.754, 0.746, 0.721 and 0.689 respectively. Conclusions The incidence of delirium in postoperative patients with hip fracture is rather high, especially for patients with old age and history of delirium. Monitoring albumin, TSH and resting score may be beneficial to the management of postoperative delirium.

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