Predictive factor analysis of poor outcomes after early hip surgery in osteoporotic hip fracture patients

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND. Objective: To analyze the predictive factors related to the postoperative poor outcome within one year in the elderly patients sustained hip fracture (HF) and underwent early hip surgery (EHS) protocol. Materials and Methods: A single-centered, retrospective study was conducted between 2010 and 2012 on elderly patients who sustained HF and underwent EHS within 72 hours. The perioperative data and outcome were reviewed using electronic database and telephone interview. “Poor outcome” was defined as composite outcome consisting of mortality and readmission related to HF during 1-year postoperative follow-up period. Multivariate logistic regression analysis was used to identify predictive factors related to the “poor outcome” at 3-month, 6-month, and 1-year postoperatively. Results: A total of 82 HF patients were included. The average patients’ age was 79 years (range 58 to 94 years). Sixty-four patients (75.6%) were female. The 1-year mortality was 11% (n = 9). The prevalence of poor outcome at 3-month, 6-month, and 1-year were 22.0%, 25.6%, and 31.7%, respectively. On multivariate analysis, hypoalbuminemia was significantly associated with the 3-month (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.68 to 0.88, p=0.0001), 6-month (OR 0.88, 95% CI 0.78 to 0.99, p=0.04), and 1-year poor outcome (OR 0.89, 95% CI 0.79 to 0.99, p=0.03); whereas grade 4 of the American Society of Anesthesiologist (ASA) physical status was significantly associated with the 6-month (OR 6.37, 95% CI 1.52 to 26.73, p=0.01) and 1-year poor outcome (OR 5.11; 95% CI 1.50 to 17.46, p=0.01). Conclusion: Preoperative hypoalbuminemia and grade 4 ASA status significantly correlated with the poor outcome after early hip fracture surgery.