Impact of Preoperative Analytical Values on Post-Operative Mortality Rate of Intertrochanteric Fractures

Borges, Ana Pinto; Torres, João; Simão, Ricardo São; Cabral, Abel Trigo; Pinto, Rui

doi:10.20344/amp.4280

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…Associations have been found between the surgical approach 6 , Charlson Comorbidity Index 7 , delay from admission to surgery 8 , body mass index 9 , anticoagulant consumption 10 – 12 , type of anesthesia 13 and mortality or complications following hip fractures surgery have been previously discussed. Pre-operative factors like anemia 14 , nutritional parameters 15 , analytical values 16 , blood parameters 17 , and neutrophile to lymphocyte ratio can be measured by a blood test and the prognostic role of these variables is valuable.…”

Section: Introductionmentioning

confidence: 99%

Influencing factors on morbidity and mortality in intertrochanteric fractures

Babagoli¹,

Raeini²,

Sheykhvatan³

et al. 2023

Sci Rep

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We aimed to evaluate the effect of the patient’s clinical and paraclinical condition before and after surgery on short-term mortality and complication and long-term mortality. A retrospective cohort study was conducted and multivariate logistic regression was applied to determine the effect of demographic characteristics (sex, age, AO/OTA classification, height, weight, body mass index), medical history (hypertension, ischemic heart disease, diabetes mellitus, thyroid malfunction, cancer, osteoporosis, smoking) lab data (Complete blood cell, blood sugar, Blood Urea Nitrogen, Creatinine, Na, and K), surgery-related factors (Anesthesia time and type, implant, intraoperative blood transfusion, postoperative blood transfusion, and operation time), duration of admission to surgery and anticoagulant consumption on short-term mortality and complication and long-term mortality. Three hundred ten patients from November 2016 to September 2020 were diagnosed with an intertrochanteric fracture. 3.23% of patients died in hospital, 14.1% of patients confronted in-hospital complications, and 38.3% died after discharge till the study endpoint. ΔNumber of Neutrophiles is the primary determinant for in-hospital mortality in multivariate analysis. Age and blood transfusion are the main determinants of long-term mortality, and Na before surgery is the primary variable associated with postoperative complications. Among different analytical factors Na before surgery as a biomarker presenting dehydration was the main prognostic factor for in hospital complications. In hospital mortality was mainly because of infection and long-term mortality was associated with blood transfusion.

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Section: Introductionmentioning

confidence: 99%

Influencing factors on morbidity and mortality in intertrochanteric fractures

Babagoli¹,

Raeini²,

Sheykhvatan³

et al. 2023

Sci Rep

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show abstract

“…Intertrochanteric fracture is a severe and common injury that occurs predominantly in the elderly [1–4] and is associated with high rates of morbidity and mortality [5–7]. As populations age, the number of hip fractures increase; the mortality rates range from 15 to 30% [8].…”

Section: Introductionmentioning

confidence: 99%

Comparison of intramedullary and extramedullary fixation of stable intertrochanteric fractures in the elderly: a prospective randomised controlled trial exploring hidden perioperative blood loss

Cai

Wang

et al. 2016

BMC Musculoskelet Disord

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BackgroundHip fracture is a severe and common injury that occurs predominantly in the elderly. Blood loss in the perioperative period is associated with a greater risk of dying in anaemic patients. The aim of the study was to explore the best way to treat stable intertrochanteric fractures, taking hidden blood loss into account.MethodsThis prospective, randomised blinded study included patients aged over 65 years with stable intertrochanteric fractures (Evans grades I and II). The patients were allocated to one of two groups treated via extramedullary or intramedullary fixation. Patient data were retrieved from electronic charts. Functional recovery was evaluated using the Functional Recovery Score of Zuckerman. Postoperative complications were also recorded. The formula of Nadler and Gross was used to calculate blood loss.ResultsThere were 92 patients in the extramedullary and 106 in the intramedullary group. Age, sex, the cause of injury, the type of fracture, the observed blood loss, functional recovery, time to union, complications, and American Society of Anesthesiologists classification did not differ significantly between the two groups (all p-values > 0.05). The frequencies of lung infection, electrolyte imbalance, and hypoproteinemia differed between groups (all p-values < 0.05). Total and hidden blood loss were higher in the intramedullary group (p = 0.001).ConclusionExtramedullary (compared with intramedullary) fixation of stable intertrochanteric fractures significantly reduces perioperative blood loss but affords similar functional outcomes and times to union. In view of the morbidity and complications associated with acute anaemia and transfusions, extramedullary fixation may be the optimal choice for treatment of stable fractures, being associated with reduced blood loss.Trial registrationThe study was retrospectively registered at the Chinese Clinical Trial Registry, number: ChiCTR-INQ-16009754, trial registration date: 6th Nov. 2016.

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“…Among these, preoperative anemia is a common symptom among geriatric patients who have suffered from this type of fractures [2] being caused mainly by hemodilution due to hydroelectrolytic rebalancing process, but also through blood loss from the fracture site [3]. Numerous authors attempted to highlight the correlation between preoperative anemia and mortality [4,5].…”

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confidence: 99%

Preoperative Hemoglobin Dynamics in Patients with Trochanteric Fractures. A multivariate analysis

Gheorghevici¹,

Veliceasa²,

Puha³

et al. 2018

Rev. Chim.

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Preoperative anemia is a common finding among geriatric patients with trochanteric fractures. We assessed the dynamics of hemoglobin and the factors that influence it. A total of 780 patients with trochanteric fractures were selected. Distribution by gender showed a slightly higher proportion of female patients (64.1%). The preoperative interval ranged from a few hours to 19 days. Hospital admission period varied from 1 to 49 days. Hemoglobin ranged from 4.80 to 17.40 g/dl; 43.1% of patients had individual values below the baseline. Individually, the hemoglobin value varied from a decrease of 9.33 g/dL to an increase of 11.97 g/dL, but the total study group recorded an average decrease of 0.96 � 1.75 g/dL. Hemoglobin had a downward trend directly correlated with the preoperative interval period. Decrease in hemoglobin was correlated with the percentage of blood lymphocytes, PLT/WBC ratio, prothrombin activity and APTT ratio. A low level of hemoglobin variation was associated with a shorter preoperative interval, reduced prothrombin time, prothrombin activity ] 100, INR ] 1.50 and APTT ] 30.

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Impact of Preoperative Analytical Values on Post-Operative Mortality Rate of Intertrochanteric Fractures

Cited by 6 publications

References 12 publications

Influencing factors on morbidity and mortality in intertrochanteric fractures

Influencing factors on morbidity and mortality in intertrochanteric fractures

Comparison of intramedullary and extramedullary fixation of stable intertrochanteric fractures in the elderly: a prospective randomised controlled trial exploring hidden perioperative blood loss

Preoperative Hemoglobin Dynamics in Patients with Trochanteric Fractures. A multivariate analysis

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