<p>Early Postoperative Hypoalbuminaemia as a Risk Factor for Postoperative Pneumonia Following Hip Fracture Surgery</p>

Abstract

Purpose: Postoperative pneumonia is a common and devastating complication of hip fracture surgery in older individuals. This study aimed to determine the relationship between early postoperative hypoalbuminaemia and pneumonia after hip fracture surgery. Patients and Methods: In this retrospective cohort study conducted at one centre, we reviewed the medical records of 1155 consecutive patients (>60 years) who underwent hip fracture surgery. Multivariate logistic regression analysis was performed to identify the independent risk factors for postoperative pneumonia. After determining the cutoff value for postoperative serum albumin, the patients were divided into two groups according to the minimum serum albumin level recorded during the first two postoperative days: group A included patients with a minimum serum album level less than 3.0 g/dL and group B included patients with a minimum serum album level of at least 3.0 g/dL. The prevalence of postoperative pneumonia was analysed using inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) analyses. Results: The incidence of postoperative pneumonia following hip fracture surgery was 5.1% (n=59). Age, cardiovascular disease, and early postoperative hypoalbuminaemia during the first two postoperative days were independent risk factors for postoperative pneumonia. Early postoperative hypoalbuminaemia was associated with postoperative pneumonia development in the PSM and IPTW analyses (P = 0.016 and <0.001, respectively). Conclusion: This study demonstrated that early postoperative hypoalbuminaemia is an independent risk factor for the development of postoperative pneumonia in patients undergoing hip fracture surgery.

Risk factors for postoperative pneumonia in patients undergoing hip fracture surgery: a systematic review and meta-analysis

“…POP occurs frequently in patients undergoing hip fracture surgery, particularly in older patients. Results of this meta-analysis revealed that the overall prevalence of POP was 4.8%, which was comparable to the previously reported range of 4.1–15.3% in patients with hip fracture [ 7 – 9 , 11 ]. POP is closely associated with prolonged hospital stay and significantly increased mortality [ 5 – 8 ].…”

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

“…2f). However, after sensitivity analysis by eliminating studies published after 2020, the I 2 value for five studies 4,5,8,10,13 decreased to 0%, and the significance remained unchanged ( OR = 2.21, 95% CI : 1.61–3.02, P < 0.0001) (Fig. S1d).…”

“…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 .…”

Relationship Between Preoperative Hypoalbuminemia and Postoperative Pneumonia Following Geriatric Hip Fracture Surgery: A Propensity-Score Matched and Conditional Logistic Regression Analysis

“…Toshihiro et al 30 investigated 426 elderly patients undergoing surgery for hip fracture and found postoperative hypoalbuminemia was associated with 5.8-fold increased risk of postoperative pneumonia. Shin et al 2 investigated 1,155 elderly patients undergoing surgery for hip fracture and found postoperative hypoalbuminemia was associated with 2.4-fold increased risk of postoperative pneumonia. In their study, multivariate regression analysis was also used, similar to ours and the cut-off value for albumin level was determined as 3.0g/L and 3.5g/L.…”