Acute kidney injury following hip fracture.

Acute Kidney Injury / diagnosis Aged Female Finland / epidemiology Hip Fractures / complications Hospital Mortality Humans Incidence Kidney Function Tests / methods Length of Stay / statistics & numerical data Male Outcome and Process Assessment, Health Care Perioperative Care / methods Retrospective Studies Risk Factors Survival Analysis
AKI Acute kidney injury Hip fracture Incidence Mortality

Journal

Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040

Informations de publication

Date de publication:
Dec 2019
Historique:
received: 18 02 2019
accepted: 03 10 2019
pubmed: 19 10 2019
medline: 27 11 2020
entrez: 19 10 2019
Statut: ppublish

Résumé

Hip fracture causes disability and excess mortality in the aging population. Acute kidney injury (AKI), is known to diminish survival of critically ill and trauma patients. AKI is also a common perioperative complication among surgical patients. We examined the effect of AKI on the survival of hip fracture patients in a Finnish hip fracture population and the risk factors for AKI in a prospective study. The study cohort constituted of 486 consecutive low-energy trauma hip fracture patients referred to Satakunta Central Hospital (Pori, Finland) and Turku University Hospital (Turku, Finland). The patients underwent standard diagnostics and treatment in the emergency department (ER) and were operated according to the local treatment protocol. Serum creatinine (sCr) was analyzed daily pre- and post-operatively during the hospital stay. Patients were divided into groups; AKI and non-AKI based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. The incidence of AKI in the study cohort was 8.4% (40/475). Eleven patients were excluded due to missing sCr data. The baseline characteristics of AKI and non-AKI groups differed significantly concerning baseline sCr but were otherwise similar. At 90-day follow-up, the overall mortality was 14.4%. Patients with AKI had a significantly higher mortality (35.0%) than those with no AKI (12.7%) (p < 0.001). Dementia, preoperative sCr and any stage of AKI were independent predictors for mortality. Dementia and preoperative sCr were independently associated with post-operative AKI. In this study AKI was a significant factor associated with a 3 -fold mortality during the first three months after surgery for low-energy trauma hip fracture.

Sections du résumé

BACKGROUND BACKGROUND
Hip fracture causes disability and excess mortality in the aging population. Acute kidney injury (AKI), is known to diminish survival of critically ill and trauma patients. AKI is also a common perioperative complication among surgical patients. We examined the effect of AKI on the survival of hip fracture patients in a Finnish hip fracture population and the risk factors for AKI in a prospective study.
METHODS METHODS
The study cohort constituted of 486 consecutive low-energy trauma hip fracture patients referred to Satakunta Central Hospital (Pori, Finland) and Turku University Hospital (Turku, Finland). The patients underwent standard diagnostics and treatment in the emergency department (ER) and were operated according to the local treatment protocol. Serum creatinine (sCr) was analyzed daily pre- and post-operatively during the hospital stay. Patients were divided into groups; AKI and non-AKI based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria.
RESULTS RESULTS
The incidence of AKI in the study cohort was 8.4% (40/475). Eleven patients were excluded due to missing sCr data. The baseline characteristics of AKI and non-AKI groups differed significantly concerning baseline sCr but were otherwise similar. At 90-day follow-up, the overall mortality was 14.4%. Patients with AKI had a significantly higher mortality (35.0%) than those with no AKI (12.7%) (p < 0.001). Dementia, preoperative sCr and any stage of AKI were independent predictors for mortality. Dementia and preoperative sCr were independently associated with post-operative AKI.
CONCLUSION CONCLUSIONS
In this study AKI was a significant factor associated with a 3 -fold mortality during the first three months after surgery for low-energy trauma hip fracture.

Identifiants

DOI: 10.1016/j.injury.2019.10.008 PMID: 31623901
pubmed: 31623901
pii: S0020-1383(19)30589-3
doi: 10.1016/j.injury.2019.10.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2268-2271

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Ida Rantalaiho (I)

Department of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, P.O. Box 28, FIN-20701, Turku, Finland. Electronic address: ida.rantalaiho@tyks.fi.

Jarmo Gunn (J)

Heart Center, Turku University Hospital, Turku, Finland; Department of Surgery, University of Turku, Turku, Finland.

Juha Kukkonen (J)

Department of Surgery, Division of Orthopaedic and Trauma Surgery, Satakunta Central Hospital, Pori, Finland.

Antti Kaipia (A)

Department of Urology, Tampere University Hospital and University of Tampere, Tampere, Finland.

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Classifications MeSH

questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Maladies du rein › Insuffisance rénale › Atteinte rénale aigüe › Acute kidney injury following hip fracture.
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Acute kidney injury following hip fracture.
questionsmedicales.fr › Régions géographiques › Europe › Pays nordiques et scandinaves › Finlande › Acute kidney injury following hip fracture.
questionsmedicales.fr › Plaies et blessures › Traumatismes de la jambe › Fractures du fémur › Fractures de la hanche › Acute kidney injury following hip fracture.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Mortalité › Mortalité hospitalière › Acute kidney injury following hip fracture.
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Acute kidney injury following hip fracture.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Acute kidney injury following hip fracture.
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic urologique › Tests de la fonction rénale › Acute kidney injury following hip fracture.
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Durée du séjour › Acute kidney injury following hip fracture.
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Acute kidney injury following hip fracture.
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Soins périopératoires › Acute kidney injury following hip fracture.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Acute kidney injury following hip fracture.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Acute kidney injury following hip fracture.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › Acute kidney injury following hip fracture.