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5. 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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29. 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

30. 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

33. Influence of time to surgery on clinical outcomes in elderly hip fracture patients

Author

van Rijckevorsel, Veronique A. J. I. M., de Jong, Louis, Verhofstad, Michael H. J., and Roukema, Gert R.

Abstract

AimsFactors associated with high mortality rates in geriatric hip fracture patients are frequently unmodifiable. Time to surgery, however, might be a modifiable factor of interest to optimize clinical outcomes after hip fracture surgery. This study aims to determine the influence of postponement of surgery due to non-medical reasons on clinical outcomes in acute hip fracture surgery.MethodsThis observational cohort study enrolled consecutively admitted patients with a proximal femoral fracture, for which surgery was performed between 1 January 2018 and 11 January 2021 in two level II trauma teaching hospitals. Patients with medical indications to postpone surgery were excluded. A total of 1,803 patients were included, of whom 1,428 had surgery < 24 hours and 375 had surgery ≥ 24 hours after admission.ResultsProlonged total length of stay was found when surgery was performed ≥ 24 hours (median 6 days (interquartile range (IQR) 4 to 9) vs 7 days (IQR 5 to 10); p = 0.001) after admission. No differences in postoperative length of hospital stay nor in 30-day mortality rates were found. In subgroup analysis for time frames of 12 hours each, pressure sores and urinary tract infections were diagnosed more frequently when time to surgery increased.ConclusionLonger time to surgery due to non-medical reasons was associated with a higher incidence of postoperative pressure sores and urinary tract infections when time to surgery was more than 48 hours after admission. No association was found between time to surgery and 30-day mortality rates or postoperative length of hospital stay.Cite this article: Bone Joint J2022;104-B(12):1369–1378.

Published
2022
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35. Verzamelde geschriften : ter gelegenheid van zijn 70sten verjaardag, met medewerking der Nederlandsche Regeering uitgegeven door zijne vrienden en vereerders.

Author

Beijerinck, M. W. (Martinus Willem), 1851-1931, Dooren de Jong, Louis Edmond den, Iterson, G. van (Gerrit), 1878, Kluyver, A. J. (Albert Jan), 1888-1956, Gerstein - University of Toronto (archive.org), Beijerinck, M. W. (Martinus Willem), 1851-1931, Dooren de Jong, Louis Edmond den, Iterson, G. van (Gerrit), 1878, and Kluyver, A. J. (Albert Jan), 1888-1956

Subjects
(Martinus Willem), Beijerinck, M. W, Botany, Collected Works, Microorganisms, Plant diseases
Published
1921

42. Current decision making and short-term outcome in patients with degenerative aortic stenosis: the Pooled-RotterdAm-Milano-Toulouse In Collaboration Aortic Stenosis survey

Author

Van Mieghem, Nicolas M., primary, Dumonteil, Nicolas, additional, Chieffo, Alaide, additional, Roux, Yann, additional, van der Boon, Robert M.A, additional, Giustino, Gennaro, additional, Hartman, Eline, additional, Aga, Yaar, additional, de Jong, Louis, additional, Abi Ghanem, Moussa, additional, Marcheix, Bertrand, additional, Cavazza, Caterina, additional, Carrié, Didier, additional, Colombo, Antonio, additional, Kappetein, Arie-Pieter, additional, de Jaegere, Peter P.T., additional, and Tchetche, Didier, additional

Published
2016
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46. Le score de Nottingham pour les fractures de hanche (NHFS) est-il un élément prédictif de la mortalité à 30jours après fracture cervicale vraie ?

Author

de Jong, Louis, Mal Klem, Taco, Kuijper, Tjallingius M., and Roukema, Gert R.

Abstract

The Nottingham hip fracture score (NHFS) was developed to predict 30-day mortality following a fracture of the hip. While the NHFS has been validated in three hip fracture populations within Great Britain, these studies make no distinction between the type of fracture and surgery. Literature “however” shows an increased risk for mortality after a hemi-arthroplasty following an intra-capsular hip fracture. To verify whether the mortality after an intra-capsular hip fracture is higher compared to the predicted mortality score according to the NHFS, a validation of the NHFS in patients with a hemi-arthroplasty after an intra-capsular hip fracture was performed.

Published
2019
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