Predictors of Acute Kidney Injury After Hip Fracture in Older Adults
Introduction: This study aimed to investigate the prevalence of acute kidney injury (AKI) following hip fracture surgery in geriatric patients and to identify predictors for development of AKI with a focus on possible preventable risk factors. Methods: In this retrospective cohort study, we reviewed...
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doaj-b3e4756261424c8193cae739a7ab93152020-11-25T03:35:51ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932020-04-011110.1177/2151459320920088Predictors of Acute Kidney Injury After Hip Fracture in Older AdultsJulie Braüner Christensen MD0Martin Aasbrenn MD1Luana Sandoval Castillo MD2Anette Ekmann MScPH3Thomas Giver Jensen MD4Eckart Pressel MD5Troels Haxholdt Lunn MD6Charlotte Suetta MD7Henrik Palm MD8 Department of Geriatric Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark Department of Geriatric Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark Department of Geriatric Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark Department of Geriatric Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark Department of Orthopedic Surgery, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark Department of Geriatric Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark Department of Anesthesiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark Department of Geriatric Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark Department of Orthopedic Surgery, Bispebjerg and Frederiksberg Hospital, Copenhagen, DenmarkIntroduction: This study aimed to investigate the prevalence of acute kidney injury (AKI) following hip fracture surgery in geriatric patients and to identify predictors for development of AKI with a focus on possible preventable risk factors. Methods: In this retrospective cohort study, we reviewed electronic medical records of all patients above 65 years of age who underwent hip fracture surgery at Copenhagen University Hospital, Bispebjerg, Denmark, in 2018. Acute kidney injury was assessed according to the Kidney Disease Improving Global Outcomes guidelines. Multivariate logistic regression analyses were used to identify independent risk factors for AKI. Results: Postoperative AKI developed in 28.4% of the included patients (85/299). Acute kidney injury was associated with increased length of admission (11.3 vs 8.7 days, P < .001) and 30-day mortality (18/85 vs 16/214, P = .001). In multivariable analysis, higher age (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01-1.08, P = .004), heart disease (OR: 1.78, 95% CI: 1.01-3.11, P = .045), and postoperative blood transfusion (OR: 1.84, 95% CI: 1.01-3.36, P = .048) were associated with AKI. Moreover, a higher postoperative C-reactive protein (199.0 ± 99.9 in patients with AKI, 161.3 ± 75.2 in patients without AKI) and lower postoperative diastolic blood pressure were observed in patients developing AKI. Discussion and Conclusion: Acute kidney injury was common following hip fracture surgery and associated with longer admissions and increased mortality. Patients developing AKI were older and showed several postoperative similarities, including higher C-reactive protein, lower postoperative diastolic pressure, and the need for blood transfusion.https://doi.org/10.1177/2151459320920088 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Julie Braüner Christensen MD Martin Aasbrenn MD Luana Sandoval Castillo MD Anette Ekmann MScPH Thomas Giver Jensen MD Eckart Pressel MD Troels Haxholdt Lunn MD Charlotte Suetta MD Henrik Palm MD |
spellingShingle |
Julie Braüner Christensen MD Martin Aasbrenn MD Luana Sandoval Castillo MD Anette Ekmann MScPH Thomas Giver Jensen MD Eckart Pressel MD Troels Haxholdt Lunn MD Charlotte Suetta MD Henrik Palm MD Predictors of Acute Kidney Injury After Hip Fracture in Older Adults Geriatric Orthopaedic Surgery & Rehabilitation |
author_facet |
Julie Braüner Christensen MD Martin Aasbrenn MD Luana Sandoval Castillo MD Anette Ekmann MScPH Thomas Giver Jensen MD Eckart Pressel MD Troels Haxholdt Lunn MD Charlotte Suetta MD Henrik Palm MD |
author_sort |
Julie Braüner Christensen MD |
title |
Predictors of Acute Kidney Injury After Hip Fracture in Older Adults |
title_short |
Predictors of Acute Kidney Injury After Hip Fracture in Older Adults |
title_full |
Predictors of Acute Kidney Injury After Hip Fracture in Older Adults |
title_fullStr |
Predictors of Acute Kidney Injury After Hip Fracture in Older Adults |
title_full_unstemmed |
Predictors of Acute Kidney Injury After Hip Fracture in Older Adults |
title_sort |
predictors of acute kidney injury after hip fracture in older adults |
publisher |
SAGE Publishing |
series |
Geriatric Orthopaedic Surgery & Rehabilitation |
issn |
2151-4593 |
publishDate |
2020-04-01 |
description |
Introduction: This study aimed to investigate the prevalence of acute kidney injury (AKI) following hip fracture surgery in geriatric patients and to identify predictors for development of AKI with a focus on possible preventable risk factors. Methods: In this retrospective cohort study, we reviewed electronic medical records of all patients above 65 years of age who underwent hip fracture surgery at Copenhagen University Hospital, Bispebjerg, Denmark, in 2018. Acute kidney injury was assessed according to the Kidney Disease Improving Global Outcomes guidelines. Multivariate logistic regression analyses were used to identify independent risk factors for AKI. Results: Postoperative AKI developed in 28.4% of the included patients (85/299). Acute kidney injury was associated with increased length of admission (11.3 vs 8.7 days, P < .001) and 30-day mortality (18/85 vs 16/214, P = .001). In multivariable analysis, higher age (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01-1.08, P = .004), heart disease (OR: 1.78, 95% CI: 1.01-3.11, P = .045), and postoperative blood transfusion (OR: 1.84, 95% CI: 1.01-3.36, P = .048) were associated with AKI. Moreover, a higher postoperative C-reactive protein (199.0 ± 99.9 in patients with AKI, 161.3 ± 75.2 in patients without AKI) and lower postoperative diastolic blood pressure were observed in patients developing AKI. Discussion and Conclusion: Acute kidney injury was common following hip fracture surgery and associated with longer admissions and increased mortality. Patients developing AKI were older and showed several postoperative similarities, including higher C-reactive protein, lower postoperative diastolic pressure, and the need for blood transfusion. |
url |
https://doi.org/10.1177/2151459320920088 |
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