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4. Risk Factors for 30-Days Mortality After Proximal Femoral Fracture Surgery, a Cohort Study.

Author

de Haan, Eveline, Roukema, Gert R, van Rijckevorsel, Veronique AJIM, Kuijper, Tjallingius M, and de Jong, Louis

Subjects
PROXIMAL femoral fractures, MORTALITY risk factors, HIP fractures, COHORT analysis, HIP surgery
Abstract

Objective of this study was to identify new risk factors and to confirm previously reported risk factors associated with 30-day mortality after hip fracture surgery. Patients and methods: A prospective hip fracture database was used to obtain data. In total, 3523 patients who underwent hip fracture surgery between 2011 and 2021 were included. Univariable and multivariable logistic regression was used to screen and identify candidate risk factors. Twenty-seven baseline factors and 16 peri-operative factors were included in the univariable analysis and 28 of those factors were included in multivariable analysis. Results: 8.6% of the patients who underwent hip fracture surgery died within 30 days after surgery. Prognostic factors associated with 30-day mortality after hip fracture surgery were as follows: age 90– 100 years (OR = 4.7, 95% CI: 1.07– 19.98, p = 0.041) and above 100 years (OR = 11.3, 95% CI: 1.28– 100.26, p = 0.029), male gender (OR = 2.6, 95% CI: 1.97– 3.33, p < 0.001), American Society of Anesthesiologists (ASA) 3 and ASA 4 (OR = 2.1, 95% CI: 1.44– 3.14, p < 0.001), medical history of dementia (OR = 1.7, 95% CI: 1.25– 2.36, p = 0.001), decreased albumin level (OR = 0.94, 95% CI: 0.92– 0.97, p < 0.001), decreased glomerular filtration rate (GFR) (OR = 0.98, 95% CI: 0.98– 0.99, p < 0.001), residential status of nursing home (OR = 2.1, 95% CI: 1.44– 2.87, p < 0.001), higher Katz Index of Independence in Activities of Daily Living (KATZ-ADL) score (OR = 1.1, 95% CI: 1.01– 1.16, p=0.018) and postoperative pneumonia (OR = 2.4, 95% CI: 1.72– 3.38, p < 0.001). Conclusion: A high mortality rate in patients after acute hip fracture surgery is known. Factors that are associated with an increased mortality are age above 90 years, male gender, ASA 3 and ASA 4, medical history of dementia, decreased albumin, decreased GFR, residential status of nursing home, higher KATZ-ADL score and postoperative pneumonia. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Hip fractures: Optimizing clinical outcomes and improving the quality of surgical care

Author

de Jong, Louis, Verhofstad, Michiel, Roukema, Gert, and Surgery

Abstract

The demographic trends towards an ageing population in the Western world and an increasing incidence of frail elderly with significant comorbidities is an important consideration for all healthcare professionals. Since the hip fracture incidence is corresponding with the increasing incidence of frail elderly, it is of great importance to improve quality of care and reduce the rate of complications and mortality after surgery. The research described in this thesis focuses on both technical and clinical outcomes (in particular adverse events) of hip fracture surgery with special emphasis on the use of a hemiarthroplasty for femoral neck fractures.

Published
2022

7. Traumatic inguinal hernia after fall from truck on a broom

Author

Bakker, Daniel, de Jong, Louis, van Buijtenen, Jesse, Verseveld, Maria, and Surgery

Subjects
Emergency Medicine, Orthopedics and Sports Medicine, Critical Care and Intensive Care Medicine
Abstract

Background: Inguinal hernias are among the most common abdominal wall hernias but rarely caused by penetrating trauma. Case presentation: We report a case of a 61-year-old patient with a traumatic inguinal hernia after penetrating injury through the inguinal canal. Local inspection of the intestines and abdominal cavity showed no fecal spill, blood clots or signs of contamination. Therefore, no laparoscopy or laparotomy was initiated. The abdominal wall was closed using a mesh patch. No infections or re-herniation occurred. Conclusion: Clinicians could consider local exploration in the treatment of traumatic inguinal hernias.

Published
2022

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