Incidence and related factors of hypoxia associated with elderly femoral neck fractures in the emergency department setting

Hongo, Takashi; Naito, Hiromichi; Fujiwara, Toshifumi; Inaba, Masami; Fujisaki, Noritomo; Nakao, Atsunori

doi:10.1002/ams2.618

Cited by 5 publications

(8 citation statements)

References 20 publications

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“…The incidence of POP is up to 3.5 ~ 15.2% [34] and could bring a 30-day mortality rate up to 27-43% in geriatric patients with hip fracture [35,36]. Postoperative respiratory failure is signi cantly associated with preoperative hypoxemia, which is highly prevalent in geriatric patients with hip fracture [37]. Given this, we will speci cally evaluate the risk of POP and respiratory failure in participants to further determine the comparability of the two groups prior to intervention.…”

Section: Discussionmentioning

confidence: 99%

Postoperative awake prone position in geriatric patients with hip fracture: a protocol for a randomized controlled trial on the efficacy of postoperative prone position in reducing pulmonary complications and improving oxygenation

Gao

Shi

Zhang

et al. 2023

Preprint

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Introduction Postoperative pulmonary complications (PPCs) are prevalence in geriatric patients with hip fractures. Low oxygen level is one of the most important risk factors for PPCs. Prone position has been proven efficacy in improving oxygenation and delaying the progress of pulmonary diseases especially in patients with acute respiratory distress syndrome induced by multiple etiologies. The application of awake prone position (APP) has also attracted widespread attention in recent years. A randomized controlled trial (RCT) will be carried out to measure the effect of postoperative APP in a population of geriatric patients undergoing hip fracture surgery. Methods This is a RCT. Patients older than 65 years old admitted through the emergency room and diagnosed with an intertrochanteric or femoral neck fracture will be eligible for enrollment and randomized to control group with routine postoperative management of orthopedics or APP group with additional prone position for the first three consecutive postoperative days (PODs). Patients receiving conservative treatment will not be eligible for enrollment. We will record the difference in patient’s room-air-breathing arterial partial pressure of oxygen (PaO2) values between the 4th POD (POD 4) and emergency visits, morbidity of PPCs, mortality and ICU stays during hospitalization, length of hospitalization. The rates of PPCs, readmissions and mortality will be followed up for 90 PODs. Discussion We describe the protocol for a single-center RCT that will evaluate the efficacy of postoperative APP treatment in reducing pulmonary complications and improving oxygenation in geriatric patients with hip fracture. Ethics and dissemination: This protocol was approved by the independent ethics committee (IEC) for Clinical Research of Zhongda Hospital, Affiliated to Southeast University and is registered on Chinese Clinical Trial Registry. The findings of the trial will be disseminated through peer-reviewed journals. Ethics approval number: 2021ZDSYLL203-P01 Trial registration: ChiCTR, ChiCTR2100049311. Registered on 29 July 2021, https://www.chictr.org.cn/listbycreater.aspx Trial status: Recruiting. Recruitment is expected to be completed in December 2024.

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Section: Discussionmentioning

confidence: 99%

Postoperative awake prone position in geriatric patients with hip fracture: a protocol for a randomized controlled trial on the efficacy of postoperative prone position in reducing pulmonary complications and improving oxygenation

Gao

Shi

Zhang

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The incidence of POP is up to 3.5~15.2% [ 34 ] and could bring a 30-day mortality rate up to 27–43% in geriatric patients with hip fractures [ 35 , 36 ]. Postoperative respiratory failure is significantly associated with preoperative hypoxemia, which is highly prevalent in geriatric patients with hip fractures [ 37 ]. Given this, we will specifically evaluate the risk of POP and respiratory failure in participants to further determine the comparability of the two groups before intervention.…”

Section: Discussionmentioning

confidence: 99%

Postoperative awake prone position in geriatric patients with hip fractures: a protocol for a randomized controlled trial on the efficacy of postoperative prone position in reducing pulmonary complications and improving oxygenation

Gao

Shi

Zhang

et al. 2023

Trials

View full text Add to dashboard Cite

Introduction Postoperative pulmonary complications (PPCs) are prevalent in geriatric patients with hip fractures. Low oxygen level is one of the most important risk factors for PPCs. Prone position has been proven efficacy in improving oxygenation and delaying the progress of pulmonary diseases, especially in patients with acute respiratory distress syndrome induced by multiple etiologies. The application of awake prone position (APP) has also attracted widespread attention in recent years. A randomized controlled trial (RCT) will be carried out to measure the effect of postoperative APP in a population of geriatric patients undergoing hip fracture surgery. Methods This is an RCT. Patients older than 65 years old admitted through the emergency department and diagnosed with an intertrochanteric or femoral neck fracture will be eligible for enrollment and assigned randomly to the control group with routine postoperative management of orthopedics or APP group with an additional prone position for the first three consecutive postoperative days (PODs). Patients receiving conservative treatment will not be eligible for enrollment. We will record the difference in the patient’s room-air-breathing arterial partial pressure of oxygen (PaO2) values between the 4th POD (POD 4) and emergency visits, the morbidity of PPCs and other postoperative complications, and length of stay. The incidence of PPCs, readmission rates, and mortality rates will be followed up for 90 PODs. Discussion We describe the protocol for a single-center RCT that will evaluate the efficacy of postoperative APP treatment in reducing pulmonary complications and improving oxygenation in geriatric patients with hip fractures. Ethics and dissemination This protocol was approved by the independent ethics committee (IEC) for Clinical Research of Zhongda Hospital, Affiliated to Southeast University, and is registered on the Chinese Clinical Trial Registry. The findings of the trial will be disseminated through peer-reviewed journals. Ethics approval number 2021ZDSYLL203-P01 Trial registration ChiCTR ChiCTR2100049311. Registered on 29 July 2021. Trial status Recruiting. Recruitment is expected to be completed in December 2024.

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“…Data were collected using a structured checklist adapted from different studies ( 9 , 11 , 12 ). The tool was prepared in English, and data were extracted through a review of patients’ medical charts by trained data collectors.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for hypoxaemia following hip fracture surgery in elderly patients who recovered from COVID-19: a multicentre retrospective study

et al. 2023

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ObjectivesTo explore the risk factors associated with postoperative hypoxaemia in elderly patients who have recovered from coronavirus disease (COVID-19) and underwent hip fracture surgery in the short term.DesignMulticentre retrospective study.SettingThe study was performed in three first 3A-grade hospitals in China.ParticipantsA sequential sampling method was applied to select study participants. Medical records of 392 patients aged ≥65 years who had recovered from COVID-19 and underwent hip fracture surgery at three hospitals in China between 1 November, 2022, and 15 February, 2023, were reviewed.InterventionsPatients were assigned to hypoxaemia or non-hypoxaemia groups, according to whether hypoxaemia occurred after surgery. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for postoperative hypoxaemia.ResultsThe incidence of postoperative hypoxaemia was 38.01%. Statistically significant differences were found between the two groups in terms of age, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, presence of expectoration symptoms, preoperative hypoxaemia, chronic obstructive pulmonary disease, pulmonary inflammation, time between recovery from COVID-19 and surgery, anaesthetic mode, surgical procedure, intraoperative blood loss, intraoperative infusion, duration of surgery, and length of hospital stay (p < 0.05). Furthermore, patients with BMI ≥28.0 kg/m2, expectoration symptoms, presence of preoperative hypoxaemia, ASA classification III, time between recovery from COVID-19 and surgery ≤2 weeks, and general anaesthesia were potential risk factors for postoperative hypoxaemia.ConclusionObesity, expectoration symptoms, preoperative hypoxaemia, ASA classification III, time between recovery from COVID-19 and surgery ≤2 weeks, and general anaesthesia were potential risk factors for postoperative hypoxaemia in elderly patients who recovered from COVID-19 and underwent hip fracture surgery in the short term.

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Incidence and related factors of hypoxia associated with elderly femoral neck fractures in the emergency department setting

Cited by 5 publications

References 20 publications

Postoperative awake prone position in geriatric patients with hip fracture: a protocol for a randomized controlled trial on the efficacy of postoperative prone position in reducing pulmonary complications and improving oxygenation

Postoperative awake prone position in geriatric patients with hip fracture: a protocol for a randomized controlled trial on the efficacy of postoperative prone position in reducing pulmonary complications and improving oxygenation

Postoperative awake prone position in geriatric patients with hip fractures: a protocol for a randomized controlled trial on the efficacy of postoperative prone position in reducing pulmonary complications and improving oxygenation

Risk factors for hypoxaemia following hip fracture surgery in elderly patients who recovered from COVID-19: a multicentre retrospective study

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