Analysis and Predictive Modeling of Perioperative Fever in Elderly Patients Undergoing Total Hip Arthroplasty for Femoral Neck Fractures

Abstract

Objective: To investigate the risk factors for perioperative fever in elderly patients undergoing primary total hip arthroplasty (THA) due to femoral neck fractures and establish a predictive model, providing insights for clinical practice.Methods: A retrospective study was conducted, collecting data from elderly patients (>60 years) who underwent unilateral primary hip arthroplasty for femoral neck fractures at the Northern People's Hospital of Jiangsu Province from January 2016 to January 2022. A total of 286 femoral neck fracture patients were selected after screening, including 190 without fever and 96 with fever. General information, including age, gender, body mass index (BMI), preoperative comorbidities (hypertension, diabetes, coronary heart disease), hospitalization duration, preoperative use of non-steroidal anti-inflammatory drugs, preoperative levels of white blood cells, neutrophils, hemoglobin, procalcitonin (PCT), erythrocyte sedimentation rate, albumin, and D-dimer, anesthesia method, operation duration, intraoperative blood loss, postoperative transfusion, and postoperative levels of white blood cells, neutrophils, hemoglobin, PCT, erythrocyte sedimentation rate, Alb, and D-dimer were collected for both groups. Multiple logistic regression analysis was performed to identify risk factors for postoperative fever after total hip arthroplasty, and the clinical predictive model's value was evaluated using the ROC curve.Results: The multiple logistic regression analysis revealed that anesthesia method, operation duration, intraoperative blood loss, postoperative PCT, and transfusion were risk factors for postoperative fever after total hip arthroplasty, while postoperative albumin level acted as a protective factor. A predictive model was constructed, and the ROC curve was plotted, with an AUC of 0.855 (sensitivity 0.847, specificity 0.708).Conclusion: The clinical predictive model based on postoperative albumin, anesthesia method, operation duration, intraoperative blood loss, postoperative PCT, and transfusion demonstrates excellent predictive value for the occurrence of postoperative fever after total hip arthroplasty.