Mortality and serum urea and electrolytes on admission for hip fracture patients

Lewis, J.R.; Hassan, Skz; Wenn, R.; Moran, C.G.

doi:10.1016/j.injury.2006.04.121

Cited by 69 publications

(59 citation statements)

References 16 publications

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“…[12][13][14] Our study confirms the relation between simple preoperative analysis and sixmonth post-operative mortality. The median age of our study was 82 years, similarly to other studies.…”

Section: Discussionsupporting

confidence: 80%

“…As it has been stated in several other studies, [12][13][14]16 plasma creatinin levels correlate significantly with mortality, being higher in those who do not survive the first six months. On our study the median creatinin level was 0.94 mg/dL (0.5 -9.7) for the surviving group, and 1.15 mg/dL (0.5 -7.4) for the other.…”

Section: Discussionsupporting

confidence: 67%

“…The median age of our study was 82 years, similarly to other studies. 4,12,14 Despite not being statistically significant, it's true that the median age is higher on the mortality group, which we can associate with more comorbidities.…”

Section: Discussionmentioning

confidence: 82%

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

et al. 2014

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RESUMOIntrodução: A incidência das fraturas intertrocantéricas tem aumentado ao longo dos últimos anos, bem como todos os problemas a elas associados. É importante pesquisar possíveis formas de reduzir quer co-morbilidades, quer a mortalidade pós-operatória. Decidimos avaliar o impacto de alguns valores analíticos pré-operatórios na mortalidade pós-operatória de doentes com fractura intertrocantérica, com idade igual ou superior a 65 anos. Material e Métodos:De todas as fracturas intertrocantéricas admitidas entre Janeiro de 2007 e Maio 2012, 160 doentes foram incluí-dos no estudo. As variáveis estudadas foram idade, género, tempo de internamento, e dados analíticos, como hemoglobina, contagem de leucócitos e plaquetas, níveis de ureia e creatinina e concentração de sódio plasmática. Informação relativa à mortalidade foi obtida através do registo civil e, considerando um ponto de corte de seis meses após a cirurgia, os doentes foram divididos em dois grupos de acordo com a sua sobrevida. Os testes de Mann-Whitney e Chi-quadrado foram utilizados para estudar a associação entre as nossas variáveis e a sobrevida dos doentes. Resultados: A nossa população apresentava uma idade mediana de 82 anos de idade e uma maioria de mulheres (79,4%). Nos primeiros 6 meses após a cirurgia, 27 doentes dos iniciais 160 (16,1%) faleceram. A mortalidade estava relacionada com valores baixos de hemoglobina, elevados de plaquetas, elevados de creatinina e baixa concentração de sódio plasmático. Conclusão: A taxa de mortalidade pos-operatória da cirurgia da anca é elevada. Os nossos resultados podem ser utilizados para reduzir esta taxa, corrigindo valores analíticos pré-operatórios. Palavras-chave: Fracturas da Anca/mortalidade; Período Pós-Operatório. ABSTRACT Introduction:Intertrochanteric fractures incidence has been increasing over the past few years and therefore so have all the problems associated with it. It is important to search for possible ways to reduce comorbidities as well as postoperative mortality. We decided to assess the impact of some routine pre-operative analytical values on post-operative mortality of patients with inter-trochanteric fractures 65 years or older. Material and Methods:From all intertrochanteric fracture admissions between January 2007 and May 2012, 160 patients were included in this study. The variables studied were age, gender, length of hospital stay, and analytical data such as hemoglobin, total leucocyte count, platelets, urea, creatinin and plasma sodium. Follow-up data on mortality were obtained from the civil registry and, considering 6 months as the cut-off point, patients were divided into 2 groups based on their survival. Mann-Whitney and Chi square statistics were used to study the association between our variables and patients survival.Results: Our population showed a median age of 82 years old and a majority of women (79.4%). Within the first 6 months after surgery, 27 patients of the initial 160 (16.1%) died. Mortality was associated with low hemoglobin, high platelets, high creatinin...

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 67%

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

et al. 2014

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“…Other factors include the serum levels of sodium, potassium, urea, and creatinine at admission. 4 The kidneys undergo a number of involutive changes associated with aging that maintain the balance of the internal environment, although their ability to adapt to any biological stress is limited compared to that in healthy adults. 5 The structural and functional changes that appear in the aged kidney can be classified into the following 6 categories: vascular alterations, renal tubular dysfunction, tubular fragility, medullary hypotonicity, urinary obstruction, and senile hypofiltration.…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of Indirect Markers of Renal Function in Elderly Patients With Hip Fracture

López-Martínez

Tovar-Rivera

Becerra-Laparra

et al. 2014

Geriatr Orthop Surg Rehabil

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Introduction: There are risk factors associated with mortality in patients older than 70 years with hip fracture, including kidney function. However, indirect formulas to calculate glomerular filtration rate are not validated in patients older than 70 years. We analyzed whether the formula hematocrit, urea, and gender (HUGE) can be used as a prognostic factor. Material and Methods: A retrospective cohort study of 88 patients older than 70 years with a diagnosis of hip fracture. At admission, clinical and biochemical parameters were measured and glomerular filtration rate by Cockcroft-Gault, Modification Of Diet In Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and HUGE value. Accuracy to assess long-term mortality was analyzed with receiver-operating curve analysis. Cox regression analysis was performed to identify risk factor for mortality. Results: Sample included 88 patients; overall mortality was 13.63%, 17.85%, 28.57%, and 75.85% at 6 months, 1, 2, and 3 years, respectively. There was no significant difference in glomerular filtration rate by different formulas, contrary to HUGE, with higher values in the mortality group (1.83 + 6.38 vs À2.61 + 2.70, P ¼ .0001). Survival was lower in patients with higher HUGE values (22.7 months, 95% confidence interval [CI] 16.1-29.5 vs 32.9 months, 95% CI 30.2-35.7; P .001). In the Cox regression analysis, a negative HUGE value is associated with lower mortality (hazards ratio ¼ 0.238; 95% CI 0.568-0.099). Conclusion: The HUGE formula is an independent risk factor for mortality in elderly patients with hip fracture, but not the glomerular filtration rate determined by Cockcroft-Gault, MDRD, and CKD-EPI.

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“…Although highly active antiretroviral therapy (HAART) has been hugely successful in managing HIV/AIDS and increasing mean survival time, osteoporosis (6) and bone fractures (7)(8)(9) are now becoming increasingly common. Any fracture can be a significant cause of morbidity (10), and hip fractures almost always require surgery and, in the aged population, are associated with a rate of mortality as high as 30% within the first year (11).…”

mentioning

confidence: 99%

Alterations in the immuno-skeletal interface drive bone destruction in HIV-1 transgenic rats

Vikulina¹,

Fan

Yamaguchi³

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

128

117

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Osteoporosis and bone fractures are increasingly recognized complications of HIV-1 infection. Although antiretroviral therapy itself has complex effects on bone turnover, it is now evident that the majority of HIV-infected individuals already exhibit reduced bone mineral density before therapy. The mechanisms responsible are likely multifactorial and have been difficult to delineate in humans. The HIV-1 transgenic rat recapitulates many key features of human AIDS. We now demonstrate that, like their human counterparts, HIV-1 transgenic rats undergo severe osteoclastic bone resorption, a consequence of an imbalance in the ratio of receptor activator of NF-κB ligand, the key osteoclastogenic cytokine, to that of its physiological decoy receptor osteoprotegerin. This imbalance stemmed from a switch in production of osteoprotegerin to that of receptor activator of NF-κB ligand by B cells, and was further compounded by a significantly elevated number of osteoclast precursors. With the advancing age of individuals living with HIV/AIDS, low bone mineral density associated with HIV infection is likely to collide with the pathophysiology of skeletal aging, leading to increased fracture risk. Understanding the mechanisms driving bone loss in HIV-infected individuals will be critical to developing effective therapeutic strategies.AIDS | osteoprotegerin | osteoporosis | receptor activator of NF-κB ligand | osteoclast

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Mortality and serum urea and electrolytes on admission for hip fracture patients

Cited by 69 publications

References 16 publications

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

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

Clinical Impact of Indirect Markers of Renal Function in Elderly Patients With Hip Fracture

Alterations in the immuno-skeletal interface drive bone destruction in HIV-1 transgenic rats

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