Impact of Renal Function on the Surgical Outcomes of Displaced Femoral Neck Fracture in Elderly Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Recruitment and Study Design
2.2. Surgical Interventions
2.3. Renal Function Assessment
2.4. Clinical Outcomes Assessment
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Conflicts of Interest
References
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Parameter | Total (n = 181) | Group 1 (n = 96, eGFR ≥ 60) | Group 2 (n = 54, 60 > eGFR ≥ 30) | Group 3 (n = 31, eGFR < 30) | p |
---|---|---|---|---|---|
Age in years (range) | 77.1 ± 8.1 (61–94) | 79.1 ± 7.7 (61–94) | 78.2 ± 7.9 (64–94) | 74.3 ± 8.2 (63–91) | 0.078 |
Sex (male/female) | 56:125 | 29:67 | 18:36 | 9:22 | 0.412 |
BMI (kg/m2) | 22.9 ± 5.1 | 23.1 ± 4.7 | 23.3 ± 4.1 | 22.4 ± 3.6 | 0.082 |
Hemoglobin (g/dL) | 11.8 ± 1.9 | 12.7 ± 1.7 | 11.4 ± 2.4 | 10.1 ± 1.1 | 0.001 |
Medical history | |||||
Hypertension | 123 (67.9%) | 66 (68.8%) | 38 (70.3%) | 25 (80.6%) | 0.011 |
Diabetes mellitus | 91 (50.3%) | 47 (49%) | 27 (50%) | 19 (61.3%) | 0.426 |
Coronary artery disease | 36 (19.9%) | 19 (19.8%) | 17 (31.5%) | 12 (38.7%) | 0.001 |
Cerebrovascular disease | 29 (16%) | 14 (14.6%) | 11 (22.2%) | 10 (32.3%) | 0.001 |
ASA classification | |||||
I | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | |
II | 44 (24.3%) | 40 (41.7%) | 4 (7.4%) | 0 (0%) | |
III | 118 (65.2%) | 56 (58.3%) | 44 (81.5%) | 18 (58.1%) | |
IV | 19 (10.5%) | 0 (0%) | 6 (11.1%) | 13 (41.9%) | |
Operation time (mins) | 92.5 ± 46.4 | 93 ± 41.7 | 89.1 ± 42.7 | 89.8 ± 48.4 | 0.725 |
Hospital stay (days) | 11.8 ± 15.9 | 9.1 ± 8.7 | 10.4 ± 4.4 | 22.6 ± 37.5 | 0.001 |
Complications | Total (n = 181) | Group 1 (n = 96, eGFR ≥ 60) | Group 2 (n = 54, 60 > eGFR ≥ 30) | Group 3 (n = 31, eGFR < 30) | p |
---|---|---|---|---|---|
Surgical complications | 20 (11%) | 6 (6.3%) | 7 (13%) | 7 (22.6%) | <0.001 |
Medical complications | 13 (7.2%) | 5 (5.2%) | 6 (11.1%) | 6 (19.4%) | 0.056 |
Total complications | 33 (18.2%) | 11 (10.5%) | 13 (24.1%) | 13 (42%) | <0.001 |
2-year mortality | 29 (16%) | 12 (12.5%) | 8 (14.8%) | 9 (29%) | 0.043 |
Case | eGFR Group | Age | Sex | Complications | Time (Postoperative Months) | Treatment |
---|---|---|---|---|---|---|
1 | 1 | 76 | M | Periprosthetic fracture | 1 | Operation |
2 | 1 | 74 | M | Dislocation | 3 | Closed reduction |
3 | 1 | 76 | F | Periprosthetic fracture | 6 | Operation |
4 | 1 | 80 | F | Periprosthetic fracture | 6 | Conservative treatment |
5 | 1 | 77 | F | Subsidence of prosthesis | 12 | Operation |
6 | 1 | 73 | F | Myositis ossification | 10 | Conservative treatment |
7 | 2 | 73 | F | Superficial wound infection | 3 | Conservative treatment |
8 | 2 | 81 | M | Periprosthetic fracture | 15 | Operation |
9 | 2 | 70 | M | Periprosthetic fracture | 12 | Operation |
10 | 2 | 68 | F | Periprosthetic fracture | 18 | Conservative treatment |
11 | 2 | 77 | F | Periprosthetic fracture | 7 | Operation |
12 | 2 | 75 | F | Subsidence of prosthesis | 12 | Operation |
13 | 2 | 72 | F | Subsidence of prosthesis | 14 | Operation |
14 | 3 | 91 | M | Dislocation | 3 | Closed reduction |
15 | 3 | 75 | F | Subsidence of prosthesis | 8 | Conservative treatment |
16 | 3 | 75 | F | Periprosthetic fracture | 18 | Operation |
17 | 3 | 76 | F | Periprosthetic fracture | 1 | Conservative treatment |
18 | 3 | 77 | F | Periprosthetic fracture | 3 | Operation |
19 | 3 | 71 | F | Periprosthetic fracture | 39 | Conservative treatment |
20 | 3 | 78 | F | Subsidence of prosthesis | 8 | Operation |
Case | eGFR Group | Age (years) | Sex | Complications | Time (Postoperative Days) |
---|---|---|---|---|---|
1 | 1 | 88 | F | Lobar pneumonia | 14 |
2 | 1 | 87 | F | Pulmonary embolism | 3 |
3 | 1 | 92 | M | Aspiration pneumonia | 12 |
4 | 1 | 77 | F | Lobar pneumonia | 7 |
5 | 1 | 86 | M | Lobar pneumonia | 5 |
6 | 2 | 88 | F | Aspiration pneumonia | 2 |
7 | 2 | 76 | F | Myocardial ischemia | 3 |
8 | 2 | 71 | F | Lobar pneumonia | 3 |
9 | 2 | 79 | F | Pulmonary embolism | 7 |
10 | 2 | 84 | F | Lobar pneumonia | 5 |
11 | 2 | 81 | F | Lobar pneumonia | 12 |
12 | 3 | 76 | F | Aspiration pneumonia | 3 |
13 | 3 | 78 | F | Myocardial ischemia | 5 |
14 | 3 | 84 | M | Lobar pneumonia | 7 |
15 | 3 | 81 | F | Lobar pneumonia | 11 |
16 | 3 | 71 | F | Cerebrovascular accident | 2 |
17 | 3 | 71 | F | Lobar pneumonia | 5 |
Factor | Group | Univariate | Multivariate | ||
---|---|---|---|---|---|
OR (95% CI) | p Value | OR (95% CI) | p Value | ||
Age | 1 (0.93–1.07) | 0.564 | |||
Sex | 1.13 (0.38–3.4) | 0.826 | |||
BMI | 0.87 (0.76–1.01) | 0.059 | |||
Hemoglobin | 0.76 (0.57–1.02) | 0.071 | |||
eGFR group | 1 | Ref. | |||
2 | 2.45 (1.01–5.94) | 0.047 | |||
3 | 5.58 (2.16–14.43) | 0.001 | 4.33 (1.32–13.19) | 0.015 | |
Medical history | HTN | 0.62 (0.22–1.81) | 0.385 | ||
DM | 0.66 (0.24–1.81) | 0.417 | |||
CAD | 1.3 (0.39–4.33) | 0.67 | |||
CVD | 3.34 (1.52–8.4) | 0.166 | |||
ASA classification | I | ||||
II | Ref. | ||||
III | 6.38 (0.81–50.20) | 0.079 | |||
IV | 8.50 (0.68–105.75) | 0.096 | |||
Fracture type (Garden stage) | I | Ref. | |||
II | 0 | 0.999 | |||
III | 3.89 (0.41–37.19) | 0.24 | |||
IV | 2.05 (0.25–17.02) | 0.507 | |||
Operation time | 1 (0.99–1.01) | 0.441 | |||
Hospital stay | 1.05 (1.01–1.09) | 0.067 |
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Kwon, H.M.; Lim, S.; Yang, I.-H.; Lee, W.-S.; Jeon, B.H.; Park, K.K. Impact of Renal Function on the Surgical Outcomes of Displaced Femoral Neck Fracture in Elderly Patients. J. Clin. Med. 2019, 8, 1149. https://doi.org/10.3390/jcm8081149
Kwon HM, Lim S, Yang I-H, Lee W-S, Jeon BH, Park KK. Impact of Renal Function on the Surgical Outcomes of Displaced Femoral Neck Fracture in Elderly Patients. Journal of Clinical Medicine. 2019; 8(8):1149. https://doi.org/10.3390/jcm8081149
Chicago/Turabian StyleKwon, Hyuck Min, Suhan Lim, Ick-Hwan Yang, Woo-Suk Lee, Byeong Hun Jeon, and Kwan Kyu Park. 2019. "Impact of Renal Function on the Surgical Outcomes of Displaced Femoral Neck Fracture in Elderly Patients" Journal of Clinical Medicine 8, no. 8: 1149. https://doi.org/10.3390/jcm8081149