Sepsis Within 30 Days of Geriatric Hip Fracture Surgery

Bohl, Daniel D.; Iantorno, Stephanie E.; Saltzman, Bryan M.; Tetreault, Matthew W.; Darrith, Brian; Valle, Craig J. Della

doi:10.1016/j.arth.2017.05.024

Cited by 19 publications

(20 citation statements)

References 31 publications

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“…Patients with a history of sepsis demonstrated a tendency to lower mortality than those without in the present study. In contrast to, the vast majority of previous studies have indicated that sepsis is an independent risk factor of thirty-day mortality [ 31 ]. This may be due to the fact that in this present study we excluded in-hospital dead patients from the analysis and these patients might have developed severe sepsis and subsequently died during admission.…”

Section: Discussionmentioning

confidence: 93%

One-year mortality rate after fragility hip fractures and associated risk in Nan, Thailand

Daraphongsataporn¹,

Saloa²,

Sriruanthong³

et al. 2020

Osteoporosis and Sarcopenia

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Objectives Fragility hip fracture is a common secondary complication of osteoporosis, which leads to significant morbidity and mortality. The incidence and prevalence of hip fractures have increased over recent decades. This study established an objective to determine the mortality rate and potential risk factors in fragility hip fracture patients. Methods Electronic medical records were retrospectively reviewed. A total of 1412 patients, aged 50 years and over, who sustained and received treatment for hip fractures between 2014 and 2018 were subsequently identified. Mortality rate data were retrieved from the official statistics registry for the provincial population. The mortality rates and potential risk factors for mortality were examined using Kaplan-Meier estimates and multivariate Cox proportional hazard models. Results The overall 1-year mortality rate of fragility hip fracture patients was 19%. Compared with the age-matched population in Nan province, hip fractures increased the mortality rate by 6.21 times. Additionally, the mortality of hip fracture patients was significantly higher among those with age above 80 years, nonambulatory status before fracture and upon hospital discharge, end-stage renal disease, delirium, and pneumonia. Conclusions Patients who sustained hip fractures had approximately 6 times higher mortality. Effective strategies for hip fracture prevention as well as improvement in the standard of care are crucial steps towards reducing mortality in patients with hip fracture.

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Section: Discussionmentioning

confidence: 93%

One-year mortality rate after fragility hip fractures and associated risk in Nan, Thailand

Daraphongsataporn¹,

Saloa²,

Sriruanthong³

et al. 2020

Osteoporosis and Sarcopenia

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show abstract

“…[adjusted RR: 4.4 (95 % CI: 3.7-5.4)]. [12] This disparity might potentially be explained by immortal time bias in previous studies, as we were the only study using time-varying exposure in order to avoid a potential underestimation of the association. However, changes could also be related to differences in exposure time and it's definition, different use of adjusted variables, or the differences in characteristics of the study populations and sample size.…”

Section: Discussionmentioning

confidence: 94%

“…[9] However, the impact of infections on all-cause mortality after hip fracture surgery is not clear. Previous research has shown that the 30-days mortality after hip fracture surgery is 27-43 % following pneumonia, [3,10,11] 21 % following sepsis, [12] and 19 % following deep infection. [13] However, to the best of our knowledge, no previous studies have evaluated the mortality risk after any infection or used a population-based design.…”

Section: Introductionmentioning

confidence: 99%

Increased risk of mortality after postoperative infection in hip fracture patients

Kjørholt

Kristensen

Prieto‐Alhambra

et al. 2019

Bone

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Background: Postoperative infection is a common complication in hip fracture patients and the risk appears to have increased during the last decade. However, the impact of infection on mortality after hip fracture surgery remains unclear. Purpose: We aimed to examine the association between infection (any, as well as specific infections), with all-cause mortality following hip fracture surgery. Methods: Using Danish nationwide registries, we conducted a population-based cohort study on 74,771 hip fracture patients ≥ 65 years old operated from 2005-2016. We included hospital-treated infection as a time-varying exposure, and calculated 30-days mortality rate per 1000 person-years (PY). We used time-varying Cox Proportional Hazard Regression to compute 30-days adjusted hazards ratios (aHRs) with 95 % confidence interval (CI) comparing the mortality of hip fracture patients with and without infections. We adjusted for sex, age, comorbidities, medication use, and marital status. Results: Within 30 days of surgery, 9,592 (12.8%) patients developed a hospital-treated infection. Among these, 30-days mortality was 8.43 per 1000 PY compared with 3.34 among patients without infection (aHR=2.72, 95 % CI: 2.56-2.88). For patients who developed pneumonia, aHR was 4.18 (95 % CI: 3.91-4.48), whereas the aHR was 8.86 (95 % CI: 7.88-9.95) for patients who developed systemic sepsis. For patients who sustained reoperation due to infection, aHR was 2.95 (95 %CI: 1.88-4.64). The mortality was higher in infected vs. noninfected patients irrespective of patients' age, sex and comorbidity. Conclusion: Infection within 30 days of hip fracture surgery is associated with substantially increased mortality risk. Further research should improve our knowledge about patients at increased risk and prevention measures for specific infections.

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“…liegt im 7. Lebensjahrzehnt und der ASA-Score ist nur bei einer Minderheit ≥ ASA 3 [3,11]. Hygienische Risiken, die sich aus der Unterbringung in Pflegeinrichtungen ergeben, sind selten.…”

Section: Die Asymptomatische Bakteriurieunclassified

Response to the Letter to the Editor: Sitte-Zöllner A, Walcher F, Geginat G, Piatek S. Z Orthop Unfall 2017; 155: 344 – 345. doi:10.1055/s-0043-103015

et al. 2017

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Sepsis Within 30 Days of Geriatric Hip Fracture Surgery

Cited by 19 publications

References 31 publications

One-year mortality rate after fragility hip fractures and associated risk in Nan, Thailand

One-year mortality rate after fragility hip fractures and associated risk in Nan, Thailand

Increased risk of mortality after postoperative infection in hip fracture patients

Response to the Letter to the Editor: Sitte-Zöllner A, Walcher F, Geginat G, Piatek S. Z Orthop Unfall 2017; 155: 344 – 345. doi:10.1055/s-0043-103015

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