Risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort study
Abstract Background Elderly patients with hip fracture who develop perioperative acute heart failure (AHF) have a poor prognosis. The aim of the present study is to investigate the potential risks of AHF in elderly hip-fracture patients in the postoperative period and to evaluate the prognostic sign...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-07255-x |
| _version_ | 1797276209933975552 |
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| author | Wei Zhao Mingming Fu Zhiqian Wang Zhiyong Hou |
| author_facet | Wei Zhao Mingming Fu Zhiqian Wang Zhiyong Hou |
| author_sort | Wei Zhao |
| collection | DOAJ |
| description | Abstract Background Elderly patients with hip fracture who develop perioperative acute heart failure (AHF) have a poor prognosis. The aim of the present study is to investigate the potential risks of AHF in elderly hip-fracture patients in the postoperative period and to evaluate the prognostic significance of AHF. Methods A retrospective analysis was conducted on hip fracture patients at the Third Hospital of Hebei Medical University, who were continuously in hospital from September 2018 to August 2020. To identify independent risk factors for AHF in elderly patients with hip fracture, univariate and multivariate Logistic regression analysis was employed. The Kaplan-Meier survival curve illustrated the relationship between all-cause mortality in the AHF and non-AHF groups. An assessment of the correlation between baseline factors and all-cause mortality was conducted by means of univariable and multivariable Cox proportional hazards analysis. Results We eventually recruited 492 patients,318 of whom were in the AHF group. Statistical significance was found between the two groups for age group, concomitant coronary heart disease, COPD, haemoglobin level below 100 g/L on admission, albumin level below 40 g/L on admission, and increased intraoperative blood loss. Age over 75, concomitant coronary artery disease, hemoglobin level below 100 g/L and albumin level below 40 g/L on admission were independent risk factors for AHF in older hip fracture patients. The AHF group exhibited a higher incidence of perioperative complications, such as anemia, cardiovascular issues, and stress hyperglycemia, as well as all-cause mortality. Based on our COX regression analysis, we have identified that the main risk factors for all-cause mortality in AHF patients are concomitant coronary heart disease, absence of pulmonary infection, absence of diabetes, absence of cancer, and absence of urinary tract infection. Conclusion Enhancing hip fracture prevention for AHF is particularly important. It is crucial to make informed decisions to avoid poor prognoses. Patients whose age over 75 years old, concomitant coronary heart disease, hemoglobin < 100 g/L and album< 40 g/L on admission are more likely to develop perioperative AHF. To avert complications and potential fatalities, patients with AHF must receive appropriate care during the perioperative period. |
| first_indexed | 2024-03-07T15:25:05Z |
| format | Article |
| id | doaj.art-af70556190ff4c5981918210f1b03aad |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-07T15:25:05Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-af70556190ff4c5981918210f1b03aad2024-03-05T17:24:35ZengBMCBMC Musculoskeletal Disorders1471-24742024-02-0125111010.1186/s12891-024-07255-xRisk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort studyWei Zhao0Mingming Fu1Zhiqian Wang2Zhiyong Hou3Department of Geriatric Orthopedics, The Third Hospital of Hebei Medical UniversityDepartment of Geriatric Orthopedics, The Third Hospital of Hebei Medical UniversityDepartment of Geriatric Orthopedics, The Third Hospital of Hebei Medical UniversityDepartment of Orthopaedic Surgery, The Third Hospital of Hebei Medical UniversityAbstract Background Elderly patients with hip fracture who develop perioperative acute heart failure (AHF) have a poor prognosis. The aim of the present study is to investigate the potential risks of AHF in elderly hip-fracture patients in the postoperative period and to evaluate the prognostic significance of AHF. Methods A retrospective analysis was conducted on hip fracture patients at the Third Hospital of Hebei Medical University, who were continuously in hospital from September 2018 to August 2020. To identify independent risk factors for AHF in elderly patients with hip fracture, univariate and multivariate Logistic regression analysis was employed. The Kaplan-Meier survival curve illustrated the relationship between all-cause mortality in the AHF and non-AHF groups. An assessment of the correlation between baseline factors and all-cause mortality was conducted by means of univariable and multivariable Cox proportional hazards analysis. Results We eventually recruited 492 patients,318 of whom were in the AHF group. Statistical significance was found between the two groups for age group, concomitant coronary heart disease, COPD, haemoglobin level below 100 g/L on admission, albumin level below 40 g/L on admission, and increased intraoperative blood loss. Age over 75, concomitant coronary artery disease, hemoglobin level below 100 g/L and albumin level below 40 g/L on admission were independent risk factors for AHF in older hip fracture patients. The AHF group exhibited a higher incidence of perioperative complications, such as anemia, cardiovascular issues, and stress hyperglycemia, as well as all-cause mortality. Based on our COX regression analysis, we have identified that the main risk factors for all-cause mortality in AHF patients are concomitant coronary heart disease, absence of pulmonary infection, absence of diabetes, absence of cancer, and absence of urinary tract infection. Conclusion Enhancing hip fracture prevention for AHF is particularly important. It is crucial to make informed decisions to avoid poor prognoses. Patients whose age over 75 years old, concomitant coronary heart disease, hemoglobin < 100 g/L and album< 40 g/L on admission are more likely to develop perioperative AHF. To avert complications and potential fatalities, patients with AHF must receive appropriate care during the perioperative period.https://doi.org/10.1186/s12891-024-07255-xAcute heart failureHip fractureRisk factorsPrognosisElderly |
| spellingShingle | Wei Zhao Mingming Fu Zhiqian Wang Zhiyong Hou Risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort study BMC Musculoskeletal Disorders Acute heart failure Hip fracture Risk factors Prognosis Elderly |
| title | Risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort study |
| title_full | Risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort study |
| title_fullStr | Risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort study |
| title_full_unstemmed | Risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort study |
| title_short | Risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort study |
| title_sort | risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture case control studies and cohort study |
| topic | Acute heart failure Hip fracture Risk factors Prognosis Elderly |
| url | https://doi.org/10.1186/s12891-024-07255-x |
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