In-Hospital Postoperative Pneumonia Following Geriatric Intertrochanteric Fracture Surgery: Incidence and Risk Factors

Kuo Zhao,1– 3 Junzhe Zhang,1– 3 Junyong Li,1– 3 Jialiang Guo,1– 3 Hongyu Meng,1– 3 Yanbin Zhu,1– 3 Yingze Zhang,1– 3 Zhiyong Hou1– 3 1Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiaz...

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Main Authors: Zhao K, Zhang J, Li J, Guo J, Meng H, Zhu Y, Zhang Y, Hou Z
Format: Article
Language:English
Published: Dove Medical Press 2020-09-01
Series:Clinical Interventions in Aging
Subjects:
Online Access:https://www.dovepress.com/in-hospital-postoperative-pneumonia-following-geriatric-intertrochante-peer-reviewed-article-CIA
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author Zhao K
Zhang J
Li J
Guo J
Meng H
Zhu Y
Zhang Y
Hou Z
author_facet Zhao K
Zhang J
Li J
Guo J
Meng H
Zhu Y
Zhang Y
Hou Z
author_sort Zhao K
collection DOAJ
description Kuo Zhao,1– 3 Junzhe Zhang,1– 3 Junyong Li,1– 3 Jialiang Guo,1– 3 Hongyu Meng,1– 3 Yanbin Zhu,1– 3 Yingze Zhang,1– 3 Zhiyong Hou1– 3 1Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, People’s Republic of China; 2Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, People’s Republic of China; 3Orthopaedic Research Institution of Hebei Province, Shijiazhuang 050051, Hebei, People’s Republic of ChinaCorrespondence: Yingze Zhang; Zhiyong Hou Email suryzz@126.com; surzyh@126.comPurpose: The in-hospital death rate in cases of hip fracture ranges from 6% to 10%. Pneumonia is a serious complication for hip fracture patients that contributes to longer hospital stays and higher mortality rates; however, the prevalence and risk factors are not well established. To address this issue, the present study investigated the incidence of and risk factors for in-hospital postoperative pneumonia (IHPOP) following geriatric intertrochanteric fracture surgery.Patients and Methods: Information on 1495 geriatric patients (> 65 years) who underwent intertrochanteric fracture surgery at our hospital between October 2014 and December 2018 was extracted from a prospective hip fracture database and reviewed. Demographic information, clinical variables including surgical data, and preoperative laboratory indices that could potentially influence IHPOP were analyzed. Receiver operating characteristic curve analysis was performed and the optimum cutoff value for quantitative data was determined. Univariate and multivariate analyses were carried out to identify risk factors for IHPOP.Results: The incidence of IHPOP following geriatric intertrochanteric fracture surgery was 3.5% (53/1495 cases). The multivariate analysis showed that age > 82 years (odds ratio [OR]=2.54, p=0.004), male sex (OR=2.13, p=0.017), chronic respiratory disease (OR=5.02, p< 0.001), liver disease (OR=3.39, p=0.037), urinary tract infection (OR=8.46, p=0.005), creatine kinase (CK) MB> 20 U/l (OR=2.31, p=0.020), B-type natriuretic peptide (BNP) ≥ 75 ng/l (OR=4.02, p=0.001), and d-dimer > 2.26 mg/l (OR=2.69, p=0.002) were independent risks factor for the incidence of IHPOP following geriatric intertrochanteric fracture surgery.Conclusion: The incidence of IHPOP was 3.5% following geriatric intertrochanteric fracture surgery; age, male sex, chronic respiratory disease, liver disease, urinary tract infection, CKMB, BNP, and d-dimer were significant risk factors. Targeted preoperative management based on these factors could reduce the risk of IHPOP and mortality in these patients.Keywords: intertrochanteric fracture, postoperative pneumonia, in-hospital complication, geriatric population, risk factor
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spelling doaj.art-b832abe8087148c9a23761150aaffbc32022-12-21T19:21:18ZengDove Medical PressClinical Interventions in Aging1178-19982020-09-01Volume 151599160956862In-Hospital Postoperative Pneumonia Following Geriatric Intertrochanteric Fracture Surgery: Incidence and Risk FactorsZhao KZhang JLi JGuo JMeng HZhu YZhang YHou ZKuo Zhao,1– 3 Junzhe Zhang,1– 3 Junyong Li,1– 3 Jialiang Guo,1– 3 Hongyu Meng,1– 3 Yanbin Zhu,1– 3 Yingze Zhang,1– 3 Zhiyong Hou1– 3 1Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, People’s Republic of China; 2Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, People’s Republic of China; 3Orthopaedic Research Institution of Hebei Province, Shijiazhuang 050051, Hebei, People’s Republic of ChinaCorrespondence: Yingze Zhang; Zhiyong Hou Email suryzz@126.com; surzyh@126.comPurpose: The in-hospital death rate in cases of hip fracture ranges from 6% to 10%. Pneumonia is a serious complication for hip fracture patients that contributes to longer hospital stays and higher mortality rates; however, the prevalence and risk factors are not well established. To address this issue, the present study investigated the incidence of and risk factors for in-hospital postoperative pneumonia (IHPOP) following geriatric intertrochanteric fracture surgery.Patients and Methods: Information on 1495 geriatric patients (> 65 years) who underwent intertrochanteric fracture surgery at our hospital between October 2014 and December 2018 was extracted from a prospective hip fracture database and reviewed. Demographic information, clinical variables including surgical data, and preoperative laboratory indices that could potentially influence IHPOP were analyzed. Receiver operating characteristic curve analysis was performed and the optimum cutoff value for quantitative data was determined. Univariate and multivariate analyses were carried out to identify risk factors for IHPOP.Results: The incidence of IHPOP following geriatric intertrochanteric fracture surgery was 3.5% (53/1495 cases). The multivariate analysis showed that age > 82 years (odds ratio [OR]=2.54, p=0.004), male sex (OR=2.13, p=0.017), chronic respiratory disease (OR=5.02, p< 0.001), liver disease (OR=3.39, p=0.037), urinary tract infection (OR=8.46, p=0.005), creatine kinase (CK) MB> 20 U/l (OR=2.31, p=0.020), B-type natriuretic peptide (BNP) ≥ 75 ng/l (OR=4.02, p=0.001), and d-dimer > 2.26 mg/l (OR=2.69, p=0.002) were independent risks factor for the incidence of IHPOP following geriatric intertrochanteric fracture surgery.Conclusion: The incidence of IHPOP was 3.5% following geriatric intertrochanteric fracture surgery; age, male sex, chronic respiratory disease, liver disease, urinary tract infection, CKMB, BNP, and d-dimer were significant risk factors. Targeted preoperative management based on these factors could reduce the risk of IHPOP and mortality in these patients.Keywords: intertrochanteric fracture, postoperative pneumonia, in-hospital complication, geriatric population, risk factorhttps://www.dovepress.com/in-hospital-postoperative-pneumonia-following-geriatric-intertrochante-peer-reviewed-article-CIAintertrochanteric fracturepostoperative pneumoniain-hospital complicationgeriatric populationrisk factor
spellingShingle Zhao K
Zhang J
Li J
Guo J
Meng H
Zhu Y
Zhang Y
Hou Z
In-Hospital Postoperative Pneumonia Following Geriatric Intertrochanteric Fracture Surgery: Incidence and Risk Factors
Clinical Interventions in Aging
intertrochanteric fracture
postoperative pneumonia
in-hospital complication
geriatric population
risk factor
title In-Hospital Postoperative Pneumonia Following Geriatric Intertrochanteric Fracture Surgery: Incidence and Risk Factors
title_full In-Hospital Postoperative Pneumonia Following Geriatric Intertrochanteric Fracture Surgery: Incidence and Risk Factors
title_fullStr In-Hospital Postoperative Pneumonia Following Geriatric Intertrochanteric Fracture Surgery: Incidence and Risk Factors
title_full_unstemmed In-Hospital Postoperative Pneumonia Following Geriatric Intertrochanteric Fracture Surgery: Incidence and Risk Factors
title_short In-Hospital Postoperative Pneumonia Following Geriatric Intertrochanteric Fracture Surgery: Incidence and Risk Factors
title_sort in hospital postoperative pneumonia following geriatric intertrochanteric fracture surgery incidence and risk factors
topic intertrochanteric fracture
postoperative pneumonia
in-hospital complication
geriatric population
risk factor
url https://www.dovepress.com/in-hospital-postoperative-pneumonia-following-geriatric-intertrochante-peer-reviewed-article-CIA
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