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Preoperative Hemoglobin <10 g/DL Predicts an Increase in Major Adverse Cardiac Events in Patients With Hip Fracture Over 80 Years: A Retrospective Cohort Study.
- Source :
- Geriatric Orthopaedic Surgery & Rehabilitation; Jan-Dec2023, Vol. 14, p1-8, 8p
- Publication Year :
- 2023
-
Abstract
- Background: Preoperative anemia has been associated with perioperative morbidity and mortality in patients undergoing cardiac and non-cardiac surgery. Preoperative anemia is common in elderly hip fracture patients. The primary objective of the study was to explore the relationship between preoperative hemoglobin levels and postoperative major adverse cardiovascular events (MACEs) in hip fracture patients over 80 years. Methods: The retrospective study enrolled hip fracture patients over 80 years from January 2015 to December 2021 in our center. The data were collected from the hospital's electronic database after approval by the ethics committee. The primary objective of the study was to investigate MACEs, and the secondary objectives included in-hospital mortality, delirium, acute renal failure, ICU admission rate, and transfusion (>2 U). Results: 912 patients were entered for final analysis. Based on the restricted cubic spline, the risk of preoperative hemoglobin (<10 g/DL) was associated with an increased risk of postoperative complications. With univariable logistic analysis, a hemoglobin level <10 g/DL was associated with increased MACEs [OR 1.769, 95% CI (1.074, 2.914), P = .025], in-hospital mortality [OR 2.709, 95% CI (1.215, 6.039), P = .015] and transfusion >2 U risk [OR 2.049, 95% CI (1.56, 2.69), P < .001]. Even after adjustment for confounding factors, MACEs [OR 1.790, 95% CI (1.073, 2.985), P = .026], in-hospital mortality [OR 2.81, 95% CI (1.214, 6.514), P = .016] and transfusion >2 U rate [OR 2.002, 95% CI (1.516, 2.65), P < .001] were still higher in the lower hemoglobin level cohort. Moreover, a log-rank test showed increased in-hospital mortality in the cohort with a preoperative hemoglobin level of <10 g/DL. However, there was no difference in delirium, acute renal failure, and ICU admission rates. Conclusions: In conclusion, for hip fracture patients over 80 years, preoperative hemoglobin levels <10 g/DL might be associated with increased postoperative MACEs, in-hospital mortality, and transfusion >2 U. [ABSTRACT FROM AUTHOR]
- Subjects :
- KRUSKAL-Wallis Test
HEMOGLOBINS
CONFIDENCE intervals
MAJOR adverse cardiovascular events
PREOPERATIVE period
HIP fractures
SURGICAL complications
RETROSPECTIVE studies
FISHER exact test
MANN Whitney U Test
RISK assessment
HOSPITAL mortality
DESCRIPTIVE statistics
DELIRIUM
EMERGENCY medical services
CHI-squared test
STATISTICAL hypothesis testing
RESEARCH funding
LOGISTIC regression analysis
ODDS ratio
DATA analysis software
SENSITIVITY & specificity (Statistics)
LONGITUDINAL method
ACUTE kidney failure
PROBABILITY theory
PROPORTIONAL hazards models
DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 21514585
- Volume :
- 14
- Database :
- Complementary Index
- Journal :
- Geriatric Orthopaedic Surgery & Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 175370351
- Full Text :
- https://doi.org/10.1177/21514593231183611