Delayed surgery is associated with adverse outcomes in patients with hip fracture undergoing hip arthroplasty

Liu, Shencai; Li, Qiang; Yang, Qinfeng; Fan, Lei; Wang, Jian; Yang, Yuxuan; Shi, Zhanjun; Li, Tao

doi:10.1186/s12891-023-06396-9

Cited by 6 publications

(3 citation statements)

References 31 publications

(29 reference statements)

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“…It is a component of the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project. Annually, the NIS obtains a stratified sample of 20% of hospital stays from over 1000 US hospitals [ 12 , 13 ]. The International Classification of Diseases (ICD) 9th and 10th editions’ major surgical codes are used to identify patients whose primary procedure is a TH (ICD-9 and ICD-10).…”

Section: Methodsmentioning

confidence: 99%

A retrospective analysis of the incidence and risk factors of perioperative urinary tract infections after total hysterectomy

Cao,

Tu,

Zheng

et al. 2024

BMC Women's Health

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Introduction Perioperative urinary tract infections (PUTIs) are common in the United States and are a significant contributor to high healthcare costs. There is a lack of large studies on the risk factors for PUTIs after total hysterectomy (TH). Methods We conducted a retrospective study using a national inpatient sample (NIS) of 445,380 patients from 2010 to 2019 to analyze the risk factors and annual incidence of PUTIs associated with TH perioperatively. Results PUTIs were found in 9087 patients overall, showing a 2.0% incidence. There were substantial differences in the incidence of PUTIs based on age group (P < 0.001). Between the two groups, there was consistently a significant difference in the type of insurance, hospital location, hospital bed size, and hospital type (P < 0.001). Patients with PUTIs exhibited a significantly higher number of comorbidities (P < 0.001). Unsurprisingly, patients with PUTIs had a longer median length of stay (5 days vs. 2 days; P < 0.001) and a higher in-hospital death rate (from 0.1 to 1.1%; P < 0.001). Thus, the overall hospitalization expenditures increased by $27,500 in the median ($60,426 vs. $32,926, P < 0.001) as PUTIs increased medical costs. Elective hospitalizations are less common in patients with PUTIs (66.8% vs. 87.6%; P < 0.001). According to multivariate logistic regression study, the following were risk variables for PUTIs following TH: over 45 years old; number of comorbidities (≥ 1); bed size of hospital (medium, large); teaching hospital; region of hospital(south, west); preoperative comorbidities (alcohol abuse, deficiency anemia, chronic blood loss anemia, congestive heart failure, diabetes, drug abuse, hypertension, hypothyroidism, lymphoma, fluid and electrolyte disorders, metastatic cancer, other neurological disorders, paralysis, peripheral vascular disorders, psychoses, pulmonary circulation disorders, renal failure, solid tumor without metastasis, valvular disease, weight loss); and complications (sepsis, acute myocardial infarction, deep vein thrombosis, gastrointestinal hemorrhage, pneumonia, stroke, wound infection, wound rupture, hemorrhage, pulmonary embolism, blood transfusion, postoperative delirium). Conclusions The findings suggest that identifying these risk factors can lead to improved preventive strategies and management of PUTIs in TH patients. Counseling should be done prior to surgery to reduce the incidence of PUTIs. The manuscript adds to current knowledge In medical practice, the identification of risk factors can lead to improved patient prevention and treatment strategies. We conducted a retrospective study using a national inpatient sample (NIS) of 445,380 patients from 2010 to 2019 to analyze the risk factors and annual incidence of PUTIs associated with TH perioperatively. PUTIs were found in 9087 patients overall, showing a 2.0% incidence. We found that noted increased length of hospital stay, medical cost, number of pre-existing comorbidities, size of the hospital, teaching hospitals, and region to also a play a role in the risk of UTI’s. Clinical topics Urogynecology

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Section: Methodsmentioning

confidence: 99%

A retrospective analysis of the incidence and risk factors of perioperative urinary tract infections after total hysterectomy

Cao,

Tu,

Zheng

et al. 2024

BMC Women's Health

Self Cite

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“…Meanwhile, the patients in group 2 (ΔAlb ≥ 0.5 g/dL) had longer preoperative LOS. Delayed surgery was associated with adverse outcomes in patients undergoing hip arthroplasty for hip fractures [20]. Therefore, we took the preoperative LOS as a control variable in the partial correlation when the other parameter was analysed.…”

Section: Discussionmentioning

confidence: 99%

Perioperative albumin drop is a marker for surgical stress and correlate with clinical outcomes in the elderly patients undergoing hip arthroplasty for femoral neck fractures

Wang,

Liu,

et al. 2024

Preprint

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Background This single-center retrospective study investigated the correlation between the drop of perioperative albumin and clinical outcomes in the elderly patients undergoing hip arthroplasty for femoral neck fractures (FNF). Methods We investigated 278 patients 65 years of age or older who had undergone hip arthroplasty with FNF between January 2021 and March 2023. Albumin, C-reactive protein (CRP) and hemoglobin were monitored on preoperation, postoperative day-0, day-1 and day-7. The decrease of perioperative albumin (ΔAlb) was calculated by subtracting the value on day-0 from preoperation. Then patients were divided into two groups based on the ΔAlb values, with ΔAlb < 0.5 g/dL and ΔAlb ≥ 0.5 g/dL in group 1 and group 2, respectively. Results The albumin declined 0.8 g/dL from preoperation to day-1 and slowly increased by 0.3 g/dL from day-1 to day-7. The patients in group 2 had longer duration of surgery (75 minutes vs 65 minutes, P = 0.028), more intraoperative blood loss (246.7 ± 78.4 mL vs 201.5 ± 59.8 mL, P = 0.031) and changes of CRP (75.2 ± 48.1 mg/L vs 54.9 ± 44.9 mg/L, P = 0.003) comparing with the patients in group 1. Patients in group 2 had higher prevalences of postoperative complications (hypoalbuminemia: 94% vs 15%, moderate-severe anaemia: 60% vs 40%, P < 0.05) and longer postoperative length of stay (14 days vs 13 days, P = 0.045). The ΔAlb value was correlated with the duration of surgery (r= 0.3, P < 0.001), intraoperative blood loss (r = 0.2, P< 0.001), ΔCRP (r = 0.4, P < 0.001) and postoperative LOS (r= 0.2, P = 0.003). Conclusions The levels of albumin decreased significantly after surgery, while the CRP increased. Further, the perioperative albumin drop was a marker for surgical stress and correlated with adverse clinical outcomes.

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“…To account for the extensive sample volume used in other National Inpatient Sample-related studies, statistical signi cance was established at P ≤ 0.001. (16,17).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Post-Partial Hepatectomy Acute Myocardial Infarction ： A Retrospective Nationwide Inpatient Sample Database Study

Li,

Wang,

Zhou

et al. 2024

Preprint

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Background The aftermath of partial hepatectomy often results in a severe condition known as acute myocardial infarction (AMI), which may lead to death and frequently necessitates coronary angiography-directed percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Despite this, the occurrence and factors associated with AMI following partial hepatectomy have not been comprehensiveky investigated using a nationwide database. Methods This study utilized data from the National Inpatient Sample (NIS) database, covering the years 2015 to 2019, involving 81,735 patients who underwent partial hepatectomy and were categorized into two groups according to the occurrence of AMI. Patient demographics (age, sex, and race), hospital characteristics (type of admission and payer, and bed size, teaching status, and location), length of stay (LOS), total charges during hospitalization, in-hospital mortality, comorbidities, and perioperative complications were analyzed. A multivariate logistic regression analysis was conducted to ascertain independent predictors of acute myocardial infarction following partial hepatectomy. Results A total of 81,735 partial hepatectomies was identified from the National Inpatient Sample, with an overall incidence of in-hospital AMI post partial hepatectomy of 0.8%. Except for 2015, the annual incidence rate of AMI exhibited a downward trend from 2016 to 2019. Patients with AMI after partial hepatectomy were associated with prolonged hospitalization, overall expenses, usage of Medicare, and in-hospital mortality. Factors associated with AMI comprised advanced age (≥ 80 years), multiple comorbidities (n ≥ 6), coronary heart disease, congestive heart failure, coagulopathy, fluid and electrolyte disorders, neurological disorders and paralysis. Furthermore, AMI was associated with cardiac arrest, respiratory failure, acute renal failure, pulmonary embolism, stroke, gastrointestinal hemorrhage, thrombocytopenia, and pneumonia. Conclusion The present study revealed a relatively low occurrence of in-hospital AMI following partial hepatectomy, coupled with unfavorable outcomes. Exploring the risk factors associated with AMI post-partial hepatectomy is essential for optimal treatment and mitigating potential adverse outcomes. Trial registration retrospectively registered

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Delayed surgery is associated with adverse outcomes in patients with hip fracture undergoing hip arthroplasty

Cited by 6 publications

References 31 publications

A retrospective analysis of the incidence and risk factors of perioperative urinary tract infections after total hysterectomy

A retrospective analysis of the incidence and risk factors of perioperative urinary tract infections after total hysterectomy

Perioperative albumin drop is a marker for surgical stress and correlate with clinical outcomes in the elderly patients undergoing hip arthroplasty for femoral neck fractures

Risk Factors of Post-Partial Hepatectomy Acute Myocardial Infarction ： A Retrospective Nationwide Inpatient Sample Database Study

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