Timing of complications following surgery for geriatric hip fractures.
J Clin Orthop Trauma
; 10(5): 904-911, 2019.
Article
em En
| MEDLINE
| ID: mdl-31528066
ABSTRACT
INTRODUCTION:
Despite abundant literature present on complications following hip fracture surgery, few studies have focused on the timing of these complications. MATERIALS ANDMETHODS:
The 2015-2016 American College of Surgeons - National Surgical Quality Improvement Program database was queried for patients ≥65 years of age undergoing hip fracture surgery, due to trauma, using CPT-Codes for total hip arthroplasty (27130), Hemiarthroplasty (27125) and Open Reduction/Internal Fixation (ORIF) (27236, 27244, 27245). For each complication being studied, the median time to diagnosis was determined along with the interquartile range (IQR). Cox-regression analyses were used to assess complication timings between various surgeries.RESULTS:
A total of 31,738 were included in the final cohort. The median time of occurrence (days) for myocardial infarction was 2 [IQR 1-6], pneumonia 4 [IQR 2-12], stroke/CVA 3 [IQR 1-10], pulmonary embolism 5 [IQR 2-14], urinary tract infection (UTI) 8 [IQR 2-15], deep venous thrombosis (DVT) 9 [IQR 4-17], sepsis 11 [IQR 5-19], death 12 [IQR 6-20], superficial surgical site infection (SSI) 16 [IQR 12-22], deep SSI 23 [IQR 15-24] and organ/space SSI 19 [IQR 15-23]. Undergoing a THA vs. ORIF for hip fracture was associated a relatively early occurrence of pneumonia (day 3 [IQR 1-5.25]; pâ¯=â¯0.029) and urinary tract infection (day 4 [IQR 1-13]; pâ¯=â¯0.035) and a later occurrence of organ/space SSI (day 23.5 [IQR 19.5-26.75]; pâ¯=â¯0.002).CONCLUSION:
Orthopaedic trauma surgeons can utilize this data to optimize care strategies during the time-periods of highest risk to prevent complications from occurring early on in the course of post-operative care.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article