Which Patients Are at Risk for Kidney Dysfunction After Hip Fracture Surgery?

Abstract

Many patients at risk for postoperative KD can be identified and treated. Most patients recover from their KD and the majority return to full weightbearing.

Diabetes Confers Little to No Increased Risk of Postoperative Complications After Hip Fracture Surgery in Geriatric Patients

“…The only differences were an increased risk of pressure ulcers and increased congestive heart failure and renal failure at 24 months followup, comparisons that were unavailable to us owing to specifics of the ACS-NSQIP 1 database. Finally, the findings of our study are in contrast to those of some studies that have associated diabetes with an increased risk of renal complications, readmission, and mortality after hip fracture surgery [1,14,17]. However, as an example, the study that identified an increased risk of kidney disease in patients with diabetes used an increase of 0.3 mg/dL in creatinine as criteria for postoperative kidney disease.…”

“…Previous studies evaluating diabetes and operative stabilization of hip fractures have shown an increased risk of postoperative cardiac complications [10,22], renal dysfunction [10,17], urinary retention [1], extended length of hospital stay [22], and hospital readmission within 28 days [14]. Although all valuable contributions, many of these investigations were limited by small sample sizes, restriction to a single-hospital system, or lack of postdischarge followup.…”

CORR Insights®: Diabetes Confers Little to No Increased Risk of Postoperative Complications After Hip Fracture Surgery in Geriatric Patients

“…In a similar study also using the ACS NSQIP 1 database, diabetes was not a risk factor for increased 30-day minor, major, or total morbidity, or 30-day mortality [9]. The authors' findings contrast with other hip fracture series [1,3,5,6,8] where diabetes was associated with increased perioperative complications. Additionally, several studies within the joint arthroplasty literature have found that elevated long-term blood glucose levels, as measured by Hemoglobin A1c, closely correlate with short-term complications [4,7,11].…”

Impact of type 2 diabetes on postoperative outcome after hip fracture: nationwide population-based study in Taiwan

“…In addition, patients with type 2 diabetes mellitus (T2DM) are reported to have a higher HFx risk compared with patients without DM for a given age and bone mineral density or for a given Fracture Risk Assessment Tool score 22. Several studies have evaluated DM and surgical management of HFx23–28; however, the impact of DM on the postoperative outcome in patients with HFx remains controversial.…”