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. 2018 Aug;44(4):573-580.
doi: 10.1007/s00068-017-0826-2. Epub 2017 Aug 9.

Complications after hip fracture surgery: are they preventable?

E R Flikweert  1 , K W Wendt  2 , R L Diercks  3 , G J Izaks  4 , D Landsheer  2 , M Stevens  3 , I H F Reininga  2
Affiliations

Complications after hip fracture surgery: are they preventable?

E R Flikweert et al. Eur J Trauma Emerg Surg. 2018 Aug.

Abstract

Purpose: Surgery for hip fractures is frequently followed by complications that hinder the rehabilitation of patients. The aim of this study was to describe the incidence rate and type of complications, including mortality, after hip fracture surgery, and to identify the risk factors of these complications that may be amenable to prevention.

Methods: Prospective cohort study of all consecutive patients aged ≥60 treated for a hip fracture at University Medical Center Groningen between July 2009 and June 2013. All patients were treated in a comprehensive multidisciplinary care pathway. Logistic regression analyses were used to investigate which variables were significant risk factors for the occurrence of complications. Additional analyses were conducted to investigate whether the independent variables were significant risk factors for several specific complications and mortality.

Results: The study population consisted of 479 patients with a mean age of 78.4 (SD 9.5) years; 33% were men. The overall complication rate was 75%. Delirium was the complication seen most frequently (19%); the incidence of surgical complications was 9%. Most risk factors for complications were not preventable (high comorbidity rate, high age and dependent living situation). However, general anesthesia (OR 1.51; 95% CI 0.97-2.35) and delay in surgery (OR 3.16; 95% CI 1.43-6.97) may be risk factors that can potentially be prevented. Overall, the mortality risk was not higher in patients with a complication, but delirium and pneumonia were risk factors for mortality.

Conclusion: The overall complication rate after hip fracture surgery was high. Only few complications were potentially preventable.

Keywords: Complications; Frail elderly; Hip fracture.

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Conflict of interest statement

Conflict of interest

The authors Elvira Flikweert, Klaus Wendt, Ronald Diercks, Gerbrand Izaks, David Landsheer, Martin Stevens and Inge Reininga declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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