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. 2025 Mar 28;25(1):122.
doi: 10.1186/s12893-025-02862-4.

Risk factors of postoperative complications and in-hospital mortality after hip fracture among patients older than 80 years old: a retrospective study

Huawen Zhang  1 , Lulu Ma  2 , Xuerong Yu  1
Affiliations

Risk factors of postoperative complications and in-hospital mortality after hip fracture among patients older than 80 years old: a retrospective study

Huawen Zhang et al. BMC Surg. .

Abstract

Induction: The mortality and morbidity in hip fracture is a big healthcare burden. How to identify risk patients preoperatively is important. The aim of study was to evaluate the risk factors of postoperative complications and mortality in patients older than 80 years old after hip fracture surgery.

Methods: Patients older than 80 years old with the diagnosis of hip fracture who had surgical treatment from February 2013 to June 2021 at a single center in China were included for analysis. The primary outcome were postoperative complications and in-hospital mortality. Binary logistic regression was used to confirm the relationship between preoperative factors and postoperative complications/mortality.

Results: 498 patients were included for analysis. 176 patients developed 265 episodes of complications and the incidence of postoperative complication was 35.3%. Postoperative pulmonary infection was the most common complication, followed by cardiovascular complications and postoperative delirium. And there were 10 postoperative in-hospital deaths (2.0%). Preoperative Charlson comorbidity index(CCI) was associated with postoperative complications (OR = 1.243, 95%CI 1.020-1.516, P = 0.031) and mortality (OR = 2.303, 95%CI 1.351-3.925, P = 0.002). However, American society of Anesthesiologists (ASA) score was not an independent risk factor for postoperative complication and mortality.

Conclusion: CCI was the risk factor of poor postoperative outcome for patients older than 80 years old after hip fracture surgery. And CCI can be used as the potential tool of risk stratification for this group of patients.

Trial registration: This study had been registered in www.chictr.org.cn and the registration ID was ChiCTR2400085291 on June 4th 2024.

Keywords: American society of Anesthesiologists score; Charlson comorbidity index; Hip fracture; Postoperative complication.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was exempt from Institutional Review Board (IRB) review of Peking Union Medical College Hospital and was performed in accordance with the Declaration of Helsinki. The requirement for informed consent was waived due to the retrospective nature of our study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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