Pre-operative Anemia and Hyponatremia Increase the Risk of Mortality in Elderly Hip Fractures

Objectives: Pre-operative assessment is routinely performed for all hip fractures, and include a thorough clinical examination and multiple pre-operative tests. While abnormalities are often detected in many tests, they have varied effect on mortality. The purpose of the study was to assess the prevalence and impact of these abnormal tests and comorbidities.Methods: This was a prospective study of ۲۸۳ consecutive hip fracture patients aged above ۵۰ years admitted in a major trauma hospital from February ۲۰۱۹ to December ۲۰۱۹. The prevalence of abnormalities in the following tests were assessed: chest x-ray, electrocardiogram, complete blood count, serum electrolytes, renal function test, prothrombin time/international normalized ratio, and serum bilirubin. Also, presence of comorbidities were recorded. Mortality within ۹۰ days of admission was assessed.Results: ۹۱.۵% (N= ۲۵۹/۲۸۳) of the patients had at least one abnormal investigation. The most common abnormal investigation was anemia (۷۰.۳%, N= ۱۹۹/۲۸۳), followed by deranged sodium (۳۶.۴%, N= ۱۰۳/۲۸۳). ۱۷.۷% (N= ۵۰/۲۸۳) of the patients had at least one new comorbidity diagnosed after admission. The most common newly diagnosed comorbidity was hypertension (۱۰.۶%, N= ۳۰/۲۸۳). Anemia (p=۰.۰۴۴), deranged sodium (p=۰.۰۰۲), raised urea (p=۰.۰۱۸), raised creatinine (p=۰.۰۰۲), renal disease (p=۰.۰۱۵), neurological diseases (p=۰.۰۲۴), and charlson comorbidity index (p=۰.۰۰۴) were associated with increased mortality in multivariate analysis.Conclusion: Pre-operative hemoglobin, sodium, urea, and creatinine were the most important tests influencing mortality, and derangements of these should therefore be carefully evaluated and managed. Hip fracture care pathways should focus on correction of these abnormalities. Level of evidence: II

کلیدواژه ها:

Comorbidities ، Hip fracture ، Mortality ، preoperative tests