Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2006 Mar;21(3):219-25.
doi: 10.1111/j.1525-1497.2006.00318.x. Epub 2005 Dec 22.

Preoperative status and risk of complications in patients with hip fracture

Mary Ann McLaughlin  1 , Gretchen M Orosz, Jay Magaziner, Edward L Hannan, Thomas McGinn, R Sean Morrison, Tsivia Hochman, Kenneth Koval, Marvin Gilbert, Albert L Siu
Affiliations
Multicenter Study

Preoperative status and risk of complications in patients with hip fracture

Mary Ann McLaughlin et al. J Gen Intern Med. 2006 Mar.

Abstract

Background: Limited information is available on preoperative status and risks for complications for older patients having surgery for hip fracture. Our objective was to identify potentially modifiable clinical findings that should be considered in decisions about the timing of surgery.

Methods: We conducted a prospective cohort study with data obtained from medical records and through structured interviews with patients. A total of 571 adults with hip fracture who were admitted to 4 metropolitan hospitals were included.

Results: Multiple logistic regression was used to identify risk factors (including 11 categories of physical and laboratory findings, classified as mild and severe abnormalities) for in-hospital complications. The presence of more than 1 (odds ratio [OR] 9.7, 95% confidence interval [CI] 2.8 to 33.0) major abnormality before surgery or the presence of major abnormalities on admission that were not corrected prior to surgery (OR 2.8, 95% CI 1.2 to 6.4) was independently associated with the development of postoperative complications. We also found that minor abnormalities, while warranting correction, did not increase risk (OR 0.70, 95% CI 0.28 to 1.73).

Conclusions: In this study of older adults undergoing urgent surgery, potentially reversible abnormalities in laboratory and physical examination occurred frequently and significantly increased the risk of postoperative complications. Major clinical abnormalities should be corrected prior to surgery, but patients with minor abnormalities may proceed to surgery with attention to these medical problems perioperatively.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Minor and major clinical abnormalities in patients awaiting surgery.
See this image and copyright information in PMC

References

    1. Palda VA, Detsky AS. Perioperative assessment and management of risk from coronary artery disease. Ann Intern Med. 1997;127:313–28. - PubMed
    1. Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100:1043–9. - PubMed
    1. Detsky AS, Abrams HB, McLaughlin JR, et al. Predicting cardiac complications in patients undergoing noncardiac surgery. J Gen Intern Med. 1986;1:211–9. - PubMed
    1. Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery. Circulation. 2002;10:1257–67. - PubMed
    1. Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med. 1977;297:845–50. - PubMed

Publication types