Decreased glomerular filtration rate estimated by 2009 CKD-EPI equation predicts mortality in older hip fracture population

Pajulammi, Hanna; Luukkaala, Tiina; Pihlajamäki, Harri; Nuotio, Maria

doi:10.1016/j.injury.2016.04.028

Cited by 22 publications

(20 citation statements)

References 31 publications

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“…An elevated risk of surgery‐related infection after hip fracture surgery has been documented in patients receiving dialysis . However, CKD patients did not have an elevated risk of postoperative infection compared with non‐CKD patients . Similar findings were noted in our study.…”

Section: Discussionsupporting

confidence: 90%

“…Malnutrition, anemia, and chronic kidney disease‐mineral and bone disorder (CKD‐MBD) are potential risk factors affecting bony union in CKD patients . Aseptic loosening caused by nonunion and loss of fixation is the main cause of revisions after hip fracture osteosynthesis surgery in CKD patients with or without dialysis . In our study, CKD patients had a higher risk of allogeneic blood transfusion, but a trend toward a higher risk of revision surgery (mostly aseptic revision) than non‐CKD patients (Table ).…”

Section: Discussionmentioning

confidence: 53%

“…(30,31) Aseptic loosening caused by nonunion and loss of fixation is the main cause of revisions after hip fracture osteosynthesis surgery in CKD patients with or without dialysis. (13,16) In our study, CKD patients had a higher risk of allogeneic blood transfusion, but a trend toward a higher risk of revision surgery (mostly aseptic revision) than non-CKD patients ( Table 1). When revision surgery was needed, CKD patients received revision surgery 1 month earlier than non-CKD patients.…”

Section: Discussionmentioning

confidence: 61%

“…Non‐dialysis‐dependent CKD patients were found to be at significantly higher risk for complications, including infection, nonunion, and revision . Decreased renal function is also linked to increased mortality after hip fracture surgery . However, most of these studies reporting surgical outcomes were limited by small sample sizes, restriction to a single institution, or lack of dialysis patients as a comparison.…”

Section: Introductionmentioning

confidence: 99%

“…(13,14) Decreased renal function is also linked to increased mortality after hip fracture surgery. (15)(16)(17) However, most of these studies reporting surgical outcomes were limited by small sample sizes, restriction to a single institution, or lack of dialysis patients as a comparison. They also failed to report whether the stage of CKD affected outcomes after hip fracture surgery.…”

Section: Introductionmentioning

confidence: 99%

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Chronic Kidney Disease Worsens Health Outcomes in Diabetic Patients After Hip Fracture Surgery: An Asian Nationwide Population-Based Cohort Study

Huang

Chen

Lin

et al. 2019

Journal of Bone and Mineral Research

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There is an increased tendency for hip fractures in patients with chronic kidney disease (CKD). Although surgery is the mainstay of treatment for hip fractures, there is scant information on outcomes after hip fracture surgery in diabetic patients at different stages of CKD. In this population‐based cohort study, we compared the surgical outcome, readmission, and mortality rates after osteosynthesis of hip fractures in diabetic patients with different stages of renal function. Diabetic patients who received primary osteosynthesis for hip fracture between January 1997 and December 2013 were enrolled. The primary outcomes were surgical outcomes, including infection and revision surgery. The secondary outcomes were all‐cause readmission and mortality. This study included 44,065 patients; 11,954 had CKD (diabetic CKD group), 1662 patients were receiving dialysis (diabetic dialysis group), and 30,449 patients had no CKD (diabetic non‐CKD group). We found that the diabetic dialysis group had a significantly higher risk of infection and revision surgery compared with diabetic non‐CKD patients (HR = 1.52, 95% CI, 1.24 to 1.87; HR = 1.62, 95% CI, 1.33 to 1.97, respectively, both P < 0.001) and diabetic CKD patients (HR = 1.62, 95% CI, 1.32 to 1.99; HR = 1.48, 95% CI, 1.22 to 1.80, respectively, both P < 0.001). Diabetic CKD patients had a comparable risk of surgical complications including infection and revision as diabetic non‐CKD patients. For readmission and mortality, the diabetic dialysis group had the highest risk among the three groups at all time‐points (3 months after surgery, 1 year, and the last follow‐up, all P < 0.001). Compared with the diabetic non‐CKD group, the diabetic CKD group had an elevated risk of readmission and mortality at all time‐points (all P < 0.001). In conclusion, CKD was associated with worse outcomes after hip fracture fixation surgery. Although at significantly higher risk of readmission and mortality, CKD patients still had a comparable risk of infection and revision to non‐CKD patients. © 2019 American Society for Bone and Mineral Research.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 61%

Section: Introductionmentioning

confidence: 99%