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Seasonal influence on postoperative hip fracture complications: Retrospective cohort of more than 1000 patients from a tertiary-care university hospital.

ABSTRACT: Background:Hip fractures account for one of the most debilitating conditions affecting the general population amongst the developed and developing nations. Investigators aimed to study the influence of the ongoing season i.e. whether patients operated upon in summer or winter, on post-operative complications occurring within 30 days of surgical procedure for hip fractures at a tertiary care hospital and level 1 trauma center. Materials and methods:Investigators conducted a non-funded, non-commercialized retrospective cohort of 1045 patients with hip fractures managed surgically. Primary exposure was surgical procedures undertaken during the summer months (April-September). Our primary outcome was determining post-operative complication rates from January 2010 to December 2018 and evaluating impact of the season through univariate and multivariable regression analyses using Cox Proportional Hazard Algorithm with STATA V15. The work has been reported in line with the STROCSS criteria. Results:Age, ASA status, type of procedure, mechanism of injury and Charlson Comorbidity Index (CCI) were identified as significant associated factors with postoperative complications after hip fracture surgery. Although overall results revealed a rising rate of complications during the summer season with a relative risk (RR; 95% CI) of 1.1(0.89-1.32), univariate and multivariable analysis did not show any significant correlations. Conclusions:The results of this study did not demonstrate a significant seasonal variability in the rate of postoperative complications for hip fracture patients operated upon during the hot months of summer. More research is required to analyze postoperative complications in order to optimize patients' outcomes.

SUBMITTER: Hasan O

PROVIDER: S-EPMC7320232 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Seasonal influence on postoperative hip fracture complications: Retrospective cohort of more than 1000 patients from a tertiary-care university hospital.

Hasan Obada O Amin Mashal M Mahmood Fatima F Rabbani Amna A Rabbani Umar U Noordin Shahryar S

Annals of medicine and surgery (2012) 20200620

<h4>Background</h4>Hip fractures account for one of the most debilitating conditions affecting the general population amongst the developed and developing nations. Investigators aimed to study the influence of the ongoing season i.e. whether patients operated upon in summer or winter, on post-operative complications occurring within 30 days of surgical procedure for hip fractures at a tertiary care hospital and level 1 trauma center.<h4>Materials and methods</h4>Investigators conducted a non-fun ...[more]

PMID: 32612823

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Project description:BackgroundDiabetes and hip fractures in geriatric patients are common, and many elderly patients have a history of diabetes. However, the influence of diabetes on surgical complications may vary based on which particular type of diabetes a patient has. To our knowledge, no prior study has stratified patients with diabetes to compare patients with noninsulin-dependent and insulin-dependent diabetes regarding rates of postoperative adverse events, length of hospitalization, and readmission rate after surgical stabilization of hip fractures in geriatric patients.Questions/purposesWe asked whether patients with noninsulin-dependent or insulin-dependent diabetes are at increased risk (1) of sustaining an aggregated serious adverse event, aggregated minor adverse event, extended length of stay, or hospital readmission within 30 days of hip fracture surgery; (2) of experiencing any individual serious adverse event within 30 days of hip fracture surgery; and (3) of experiencing any individual minor adverse event within 30 days of hip fracture surgery.MethodsPatients older than 65 years undergoing surgery for hip fracture between 2005 and 2012 were identified (n = 9938) from the American College of Surgeons National Surgical Quality Improvement Program(®) database. This database reports events within 30 days of the surgery. Demographics were compared between three groups of patients: patients with noninsulin-dependent diabetes, patients with insulin-dependent diabetes, and patients without diabetes. Patients without diabetes served as the reference group, and the relative risks for aggregated serious adverse events, aggregated minor adverse events, length of stay greater than 9 days, and readmission within 30 days were calculated for patients with noninsulin-dependent and with insulin-dependent diabetes. We then calculated relative risks for each specific serious adverse event and minor adverse event using multivariate analyses.ResultsPatients with noninsulin-dependent and insulin-dependent diabetes were at no greater risk of sustaining an aggregated serious adverse event, aggregated minor adverse event, extended postoperative length of stay, or readmission. Among individual serious adverse events, only postoperative myocardial infarction was found to be increased in the diabetic groups (relative risk [RR] = 1.9 for noninsulin-dependent diabetes, 95% CI, 1.3-2.8; RR = 1.5 for insulin-dependent diabetes, CI, 0.9-2.6; p = 0.003). Patients with noninsulin-dependent and insulin-dependent diabetes were at no greater risk of sustaining any individual minor adverse event.ConclusionsDespite previously reported and perceived risks associated with diabetes, we found little difference in terms of perioperative risk among geriatric patients with hip fracture with noninsulin-dependent or insulin-dependent diabetes relative to patients without diabetes. Clinically, the implications of these findings will help to improve, specify, and increase the efficiency of the preoperative workup and counseling of patients with diabetes who need hip fracture surgery.Level of evidenceLevel III, case-control study. See Instructions for Authors for a complete description of levels of evidence.

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Seasonal influence on postoperative hip fracture complications: Retrospective cohort of more than 1000 patients from a tertiary-care university hospital.

Publications

Seasonal influence on postoperative hip fracture complications: Retrospective cohort of more than 1000 patients from a tertiary-care university hospital.

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