수술을 시행 받은 노인 고관절 골절 환자에서 합병증 발생의 예측인자 (The predictive factors in the emergency department associated with medical complications in older hip fracture patients underwent surgery)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 33권 / 6호 / 581 ~ 588페이지
· 저자명 : 장경덕, 이재백, 진영호, 정태오, 윤재철, 오태환, 김소은

초록

Objective: Hip fractures in elderly populations are a major public concern worldwide. This study aims to demonstrate the emergency department (ED)-related factors associated with medical complications in older patients with hip fractures who underwent surgery.
Methods: This was a retrospective observational study of 150 elderly patients (≥65 years) presenting with hip fractures in 2020. The data collected were analyzed to investigate medical complications and determine the predictors of complications after a hip fracture surgery by comparing the complication and non-complication group patients. Logistic regression analysis was applied to determine the independent predictors of postoperative medical complications.
Results: The overall complication rate was determined to be 39.3%, and delirium (40.7%) was observed to be the most common affliction. Independent walking (adjusted odds ratio [AOR], 0.459; 95% confidence interval [CI], 0.214-0.985), pre-operative medical conditions (AOR, 4.823; 95% CI, 1.735-13.408), and estimated glomerular filtration rate (eGFR; 3rd quartile [AOR, 3.224; 95% CI, 1.086-9.576], 4th quartile [AOR, 5.584; 95% CI, 1.861-16.756]) were independently associated with the development of medical complications post-surgery.
Conclusion: The overall incidence of complications following hip fracture surgery is relatively high. Independent walking, preoperative medical condition, and decreased eGFR are independent predictors of postoperative complications that can be screened in the ED in elderly hip fracture patients.

영어초록

Objective: Hip fractures in elderly populations are a major public concern worldwide. This study aims to demonstrate the emergency department (ED)-related factors associated with medical complications in older patients with hip fractures who underwent surgery.
Methods: This was a retrospective observational study of 150 elderly patients (≥65 years) presenting with hip fractures in 2020. The data collected were analyzed to investigate medical complications and determine the predictors of complications after a hip fracture surgery by comparing the complication and non-complication group patients. Logistic regression analysis was applied to determine the independent predictors of postoperative medical complications.
Results: The overall complication rate was determined to be 39.3%, and delirium (40.7%) was observed to be the most common affliction. Independent walking (adjusted odds ratio [AOR], 0.459; 95% confidence interval [CI], 0.214-0.985), pre-operative medical conditions (AOR, 4.823; 95% CI, 1.735-13.408), and estimated glomerular filtration rate (eGFR; 3rd quartile [AOR, 3.224; 95% CI, 1.086-9.576], 4th quartile [AOR, 5.584; 95% CI, 1.861-16.756]) were independently associated with the development of medical complications post-surgery.
Conclusion: The overall incidence of complications following hip fracture surgery is relatively high. Independent walking, preoperative medical condition, and decreased eGFR are independent predictors of postoperative complications that can be screened in the ED in elderly hip fracture patients.

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