Association between pre-operative complications, comorbidities, and in-hospital mortality in a hip fracture cohort: a register study in a tertiary hospital in Brazil

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dc.contributor.authorSouza, Andre Moreira Fogaça de [UNESP]
dc.contributor.authorMacola, Abner [UNESP]
dc.contributor.authorGumieiro, David Nicoletti [UNESP]
dc.contributor.authorNicolodi, Gustavo Augusto [UNESP]
dc.contributor.authorLima, Rodrigo Moreira e
dc.contributor.authorMinicucci, Marcos Ferreira [UNESP]
dc.contributor.authorAzevedo, Paula Schmidt [UNESP]
dc.contributor.authorSahota, Opinder
dc.contributor.authorLima, Lais Helena Navarro e [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionQueen’s University
dc.contributor.institutionUniversity of Nottingham
dc.date.accessioned2023-03-01T20:44:38Z
dc.date.available2023-03-01T20:44:38Z
dc.date.issued2022-08-01
dc.description.abstractPurpose: The incidence of hip fractures is increasing exponentially due to an aging Brazilian population. Older people had significant comorbidities which increases the risk of post-operative mortality. Our purpose was to examine the association between pre-operative infections and comorbidities on the risk of post-operative in-hospital mortality after proximal femur fracture surgery’s, beyond that, to evaluate the association between comorbidities and time to surgery. Methods: This is a population-based cohort retrospective study, using medical records of all six year consecutive surgical procedures for correction of hip fracture in a tertiary teaching Hospital in Brazil. The exclusion criteria aimed to exclusively allocate patients who had their first hip fracture secondary to low-energy trauma. Multivariate logistical regression was performed and receiver operating characteristic (ROC) curve with area under curve (AUC) to evaluate the sensitivity and specificity of the model. p-value < 0.05 was considered significant. Results: Final sample was composed by 856 consecutive patients with 81 years of median and 164 patients were excluded. The median length of hospital say was five days with − l mortality at 3.6%. Significant variables for increased mortality included the presence of pre-operative infection (odds ratio (OR): 3.9(1.12–8.54), chronic obstructive pulmonary disease (COPD) (OR: 3.83(1.36–10.82)), and systemic arterial hypertension (SAH) (OR: 4.1(1.18–14.25)). Development of pre-operative infection was associated with a delay to surgery (OR: 1.1 (1.08–1.13)). Conclusions: In older people with proximal femur fracture, the presence of pre-operative infection, COPD and SAH were the strongest risk factor for post-operative in-hospital mortality. Pre-operative infection was associated with statistically significant delay to surgery.en
dc.description.affiliationAnesthesiology Department Botucatu Medical School São Paulo State University
dc.description.affiliationSurgery and Orthopedic Department Botucatu Medical School São Paulo State University UNESP
dc.description.affiliationAnesthesiology Department Queen’s University
dc.description.affiliationInternal Medicine Department Botucatu Medical School São Paulo State University UNESP, Rubiao Junior s/n, SP, CEP
dc.description.affiliationOrthogeriatric Medicine University of Nottingham
dc.description.affiliationUnespAnesthesiology Department Botucatu Medical School São Paulo State University
dc.description.affiliationUnespSurgery and Orthopedic Department Botucatu Medical School São Paulo State University UNESP
dc.description.affiliationUnespInternal Medicine Department Botucatu Medical School São Paulo State University UNESP, Rubiao Junior s/n, SP, CEP
dc.format.extent1873-1880
dc.identifierhttp://dx.doi.org/10.1007/s00264-022-05443-9
dc.identifier.citationInternational Orthopaedics, v. 46, n. 8, p. 1873-1880, 2022.
dc.identifier.doi10.1007/s00264-022-05443-9
dc.identifier.issn1432-5195
dc.identifier.issn0341-2695
dc.identifier.scopus2-s2.0-85130752392
dc.identifier.urihttp://hdl.handle.net/11449/241047
dc.language.isoeng
dc.relation.ispartofInternational Orthopaedics
dc.sourceScopus
dc.subjectChronic obstructive pulmonary disease
dc.subjectComorbidities
dc.subjectHip fracture
dc.subjectRisk factors
dc.subjectSystemic arterial hypertension
dc.titleAssociation between pre-operative complications, comorbidities, and in-hospital mortality in a hip fracture cohort: a register study in a tertiary hospital in Brazilen
dc.typeArtigo

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Artigos - Anestesiologia - FMB
Artigos - Cirurgia e Ortopedia - FMB
Artigos - Clínica Médica - FMB