Lower estimated glomerular filtration rate at admission is associated with a worse outcome in older patients with hip fracture who undergo surgical treatment

Egileak

  • Carmen da Casa Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España. https://orcid.org/0000-0002-2290-126X
  • Marta Vidal-Terrancle Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de Salamanca. Salamanca. España. https://orcid.org/0009-0006-0209-7223
  • María Agustina Hierro-Estévez Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España. https://orcid.org/0000-0001-5634-1179
  • Rocío Montoya-Saenz Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de Salamanca. Salamanca. España
  • Helena Fidalgo Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España.
  • Alfonso González-Ramírez Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España. https://orcid.org/0000-0002-3223-0332
  • Carmen Pablos-Hernández Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de Salamanca. Salamanca. España. https://orcid.org/0000-0001-5083-6971
  • Juan F Blanco Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España.

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https://doi.org/10.23938/ASSN.1036

Gako-hitzak:

eGFR, Hip fracture, Mortality, Outcome, Postoperative complications

Laburpena

Background. We assessed the relationship of estimated glomerular filtration rate values at hospital admission on the outcome of surgically treated older adults who had suffered a hip fracture.

Methods. Prospective study that included patients > 65 years of age, surgically treated for primary hip fracture, with no pathologic or high-energy trauma aetiology admitted to a tertiary teaching hospital between 2018 and 2019. We stratified patients based on their estimated glomerular filtration rate at admission and examined its association to demographic and clinical variables, including 90-day post-discharge mortality.

Results. The study included 942 hip fracture patients. Lowered estimated glomerular filtration rate was significantly associated to a worsening of the functional status, higher incidence of medical postoperative complications, higher postoperative renal dysfunction, and greater number of blood transfusions. Mortality displayed a staircase pattern, increasing with decreasing estimated glomerular filtration rate. Patients with estimated glomerular filtration rate <60 had significantly higher mortality at 90 days after discharge. In-hospital mortality rate was 10.7% in hip fracture patients with chronic kidney disease who experienced a significant variation in the estimated glomerular filtration rate (>5 mL/min/1.73m2) on admission in comparison to baseline values.

Conclusion. Older adult patients treated for hip fracture with lower glomerular filtration rate values have poorer functional status and worse prognosis. A significant clinical variation of estimated glomerular filtration rate upon hospital admission for hip fracture may be associated with increased in-hospital mortality of chronic kidney disease patients.

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##submission.authorBiographies##

##submission.authorWithAffiliation##

  1. Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España.
  2. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de Salamanca. Salamanca. España.

##submission.authorWithAffiliation##

  1. Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España.
  2. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de Salamanca. Salamanca. España.

##submission.authorWithAffiliation##

  1. Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España.
  2. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de Salamanca. Salamanca. España.

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Argitaratuta

2023-04-27

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da Casa, C., Vidal-Terrancle, M., Hierro-Estévez, M. A., Montoya-Saenz, R. ., Fidalgo, H., González-Ramírez, A., Pablos-Hernández, C., & Blanco, J. F. . (2023). Lower estimated glomerular filtration rate at admission is associated with a worse outcome in older patients with hip fracture who undergo surgical treatment. Anales Del Sistema Sanitario De Navarra, 46(1), e1036. https://doi.org/10.23938/ASSN.1036

Zenbakia

bol: 46 zk: 1 (2023): enero-abril 2023

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