Postoperative Pulmonary Infection in Elderly Patients With Hip Fracture: More Attention Needed

Abstract

Background: Postoperative pulmonary infection is a serious complication in elderly patients with hip fracture, it’s necessary to identify the influencing factors of pulmonary infection in patients with hip fracture.Methods: Elderly patients with hip fractures admitted from January 1, 2020 to July 31, 2021 were included. The characteristics of patients with pulmonary infection and no infection were evaluated and compared. Logistic multivariate regression analyses were conducted to assess the risk factors of pulmonary infection.Results: 267 patients with hip fracture were included, the incidence of pulmonary infection in patients with hip fracture was 13.11%. There were significant differences in the age, diabetes mellitus, anemia, hypoalbuminemia, anesthesia method and duration of surgery between infection and no infection group, no significant differences in the gender, BMI, hypertension, hyperlipidemia, type of fracture, preoperative oxygen saturation, white blood cell count, platelet count, red blood cell count, creatinine, alanine aminotransferase, aspartate aminotransferase, estimated blood loss during surgery were detected between infection and no infection group. Logistic regression analysis showed that age≥70y(OR2.326 , 95%CI1.248~3.129), diabetes mellitus(OR2.123, 95%CI1.021~3.551), anemia(OR3.199,95%CI1.943~5.024), hypoalbuminemia(OR2.377, 95%CI1.211~3.398), general anesthesia(OR1.947, 95%CI1.115~3.038), duration of surgery≥120min(OR1.621 , 95%CI1.488~2.534) were the risk factors of pulmonary infection in elderly patients with hip fracture(all p<0.05). Escherichia Coli(33.33%), Klebsiella pneumoniae(28.57%), Staphylococcus aureus(21.43%) were the most common bacteria of pulmonary infection.Conclusion: There are many risk factors for pulmonary infection in elderly patients with hip fractures after surgery. In clinical practice, medical workers should take targeted interventions for those risk factors to reduce the risk of pulmonary infection.

Risk factors for hospital-acquired pneumonia in hip fracture patients: A systematic review and meta-analysis [RETRACTED]

“…[49] Meanwhile, patients with a history of stroke, cancer, cardiovascular events, and cognitive function dysfunction can also significantly increase the incidence of HAP. [14,23,28,[31][32][33] Poole et al believed that patients with hip fractures combined with stroke had decreased living ability to varying degrees and were prone to dysphagia and HAP, which required early intervention for protection. [50] In a nationwide cohort study, Søgaard et al confirmed the correlation between cancer and HAP.…”

“…Fourteen studies [4,6,9,14,19,20,[23][24][25]29,[31][32][33][34] reported the relationship between chronic obstructive pulmonary disease (COPD) and HAP (Table 2). Among these, 3 studies (Bohl, Salarbaks, Ying) reported a negative association between COPD and HAP, while the remaining 11 studies identified COPD as a risk factor for HAP.…”

“…Diet, chronic diseases, tumors, consumption after fracture, and blood leakage at the fracture site may all cause anemia in patients and increase the risk of HAP. [6,32] Additionally, we found studies evaluating the relationship between hyperglycemia and HAP. Although there was no statistical significance between the two in this study, we believe this is because fewer studies were included.…”