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Risk Factors Associated with Complications and Early Mortality of Hip Fracture Surgery in Elderly Patients
Povilas Masionis1, Giedrius Vaitukaitis1, Agnietė Masionienė2
1Faculty of Medicine, Institute of Clinical Medicine, Clinic of Rheumatology, Orthopaedic Traumatology and Reconstructive Surgery, Centre of Orthopedics and Traumatology, Vilnius Republican University Hospital, Vilnius University, LT-01513 Vilnius, Lithuania.
Abstract:
Background and Objectives: High rates of mortality and morbidity among elderly hip fracture patients are a recognized global issue. This study aimed to evaluate risk factors for early complications and 30-day mortality in hip fracture patients. Materials and Methods: The prospective study included 583 patients over 65 years old who sustained hip fractures from fall and underwent surgery. Each patient was followed up for 30 days and complications were recorded. Regression models were used to assess the influence of patient characteristics and laboratory markers on 30-day mortality and complications. Results: Any complication increased the risk of mortality by 5.6 times (95% CI 1.6-19.9, p = 0.008). Having > 6 comorbidities increased the risk of mortality by 8.2 (95% CI 1.9-35.5, p = 0.005) and the risk of complications by 2.3 (95% CI 1.9-35.5, p = 0.000). Patients > 85 years old had increased risk of mortality by 2.2 times (95% CI 1.2-4.1, p = 0.015) and a 1.7-fold increase in risk of complications (95% CI 1.2-2.4, p = 0.005). Vitamin D significantly predicted mortality with odds ratio of 2.1 (95% CI 1.1-4.1, p = 0.028). Serum N-terminal pro-brain natriuretic peptide levels > 780 ng/L predicted 2.3-fold increase in mortality (95% CI 1.0-4.9, p = 0.040) and a 2.6-fold risk of complications (95% CI 1.7-3.9, p = 0.000). Conclusions: Occurrence of complication increases the risk of mortality. Age and comorbidities are significant factors associated with 30-day mortality and complications. Vitamin D levels are associated with higher risk of mortality. N-terminal pro-brain natriuretic peptide levels correspond to higher risks of death and complications.
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