Effect of Chronic Kidney Disease on All-Cause Mortality After Hip Fracture Surgery: A Retrospective Cohort Study.

Autor: Jang YS; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea., Kim H; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea., Kim SY; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea., Park YS; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea., Yun I; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea., Park EC; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea., Jang SY; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. sukyong@yuhs.ac.; Department of Healthcare Management, Graduate School of Public Health, Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea. sukyong@yuhs.ac.
Jazyk: angličtina
Zdroj: Calcified tissue international [Calcif Tissue Int] 2024 Aug; Vol. 115 (2), pp. 150-159. Date of Electronic Publication: 2024 Jun 17.
DOI: 10.1007/s00223-024-01238-9
Abstrakt: In this retrospective cohort study, we investigated: (1) The impact of comorbid chronic kidney disease (CKD) on postoperative mortality in patients with a hip fracture; (2) mortality variations by dialysis type, potentially indicating CKD stage; (3) the efficacy of different hip fracture surgical methods in reducing mortality for patients with CKD. This study included 25,760 patients from the Korean National Health Insurance Service-Senior cohort (2002-2019) who underwent hip fracture surgery. Participants were categorized as CKD and Non-CKD. Mortality rate was determined using a generalized linear model with a Poisson distribution. The effect size was presented as a hazard ratio (HR) through a Cox proportional-hazard model. During follow-up, we ascertained that 978 patients (3.8%) had CKD preoperatively. Compared to the Non-CKD group, the mortality risk (HR) in the CKD group was 2.17 times higher (95% confidence interval [CI], 1.99-2.37). In sensitivity analysis, the mortality risk of in patients who received peritoneal dialysis and hemodialysis was 6.21 (95% CI, 3.90-9.87) and 3.62 times (95% CI, 3.11-4.20) higher than that of patients who received conservative care. Mortality risk varied by surgical method: hip hemiarthroplasty (HR, 2.11; 95% CI, 1.86-2.40), open reduction and internal fixation (HR, 2.21; 95% CI, 1.94-2.51), total hip replacement (HR, 2.27; 95% CI, 1.60-3.24), and closed reduction and percutaneous fixation (HR, 3.08; 95% CI, 1.88-5.06). Older patients with CKD undergoing hip fracture surgery had elevated mortality risk, necessitating comprehensive pre- and postoperative assessments and management.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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