Incidence and risk factors for postoperative pneumonia following surgically treated hip fracture in geriatric patients: a retrospective cohort study

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 5.8%. 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 reduction of postoperative pneumonia.

What are Risk Factors of Postoperative Pneumonia in Geriatric Individuals after Hip Fracture Surgery: A Systematic Review and Meta‐Analysis

“…2h). However, after sensitivity analysis by eliminating two studies with sample sizes <1000, 9,12 the I 2 value for the five other studies 4–8 decreased to 48%, and the significance remained unchanged ( OR = 2.19, 95% CI : 1.75–2.74, P < 0.0001), indicating the reliability of the result (Fig. S1e).…”

“…Seven of the 10 included studies were conducted in China. In nine of the 10 studies, [4][5][6][8][9][10][11][12][13] the average or median age of the participants was >70 years. In the one other study, the patient distribution across different age groups were reported rather than the average age; however, age >65 years was one of the inclusion criteria.…”

“…Early surgery is recommended for such patients 2 . Postoperative pneumonia (POP) is the commonest postoperative complication, with an incidence of 3.5%–15.2%, ranking second to delirium 3–13 . Negative outcomes associated with POP included prolonged hospital length of stay, more frequent intensive care unit (ICU) stays, and a higher rate of sepsis, readmission, and mortality 14–16 .…”

“… 2 Postoperative pneumonia (POP) is the commonest postoperative complication, with an incidence of 3.5%–15.2%, ranking second to delirium. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 Negative outcomes associated with POP included prolonged hospital length of stay, more frequent intensive care unit (ICU) stays, and a higher rate of sepsis, readmission, and mortality. 14 , 15 , 16 The 30‐day mortality rate for elderly patients who develop POP after hip fracture surgery was 27%–43%.…”

Association of hemoglobin level at admission with postoperative pneumonia in elderly patients with hip fracture: a retrospective cohort study

“…Several recent studies have demonstrated that low Hb level is an independent risk factor for POP in elderly patients with hip fracture [4,9], but there is also controversial report [10] and currently no cut-off value of Hb level is available. Therefore, this study retrospectively collected and analyzed the clinical data of elderly patients with hip fracture in our hospital, aiming to explore the quantitative correlation between Hb level and POP in elderly patients with hip fracture at admission, thus providing a reference level of Hb to guide preoperative blood transfusion in elderly patients with anemia.…”