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· DOS Abstracts
Risk of acute renal failure and mortality after
surgery for a fracture of the hip
Alma B Pedersen, Christian F Christiansen, Henrik Gammelager , Johnny Kahlert,
Henrik Toft Sørensen
Department of Clinical Epidemiology, Aarhus University Hospital
Background:
Fractures of the hip represent a major worldwide public health
problem, associated with significant mortality.
Purpose / Aim of Study:
We examined risk of developing acute renal failure
and the associated mortality among patients aged > 65 years undergoing sur-
gery for a fracture of the hip.
Materials and Methods:
We used medical databases to identify patients who
underwent surgical treatment for a fracture of the hip in Northern Denmark
between 2005 and 2011. Acute renal failure (ARF) was classified as stage 1, 2,
and 3 according to the Kidney Disease Improving Global Outcome criteria. We
computed the risk of developing ARF within five days after surgery with death
as a competing risk, and the short-term (six to 30 days post-operatively) and
long-term mortality (31 days to 365 days post-operatively). We calculated ad-
justed hazard ratios (HRs) for death with 95% confidence intervals (CIs).
Findings / Results:
Among 13,529 patients who sustained a fracture of the
hip, 1,717 (12.7%) developed ARF post- operatively, including 1,218 (9.0%)
with stage 1, 364 (2.7%) with stage 2, and 135 (1.0%) with stage 3 renal fail-
ure. The short-term mortality was 15.9% and 5.6% for patients with and with-
out ARF, respectively (HR 2.8, 95% CI 2.4 to 3.2). The long-term mortality was
25.0% and 18.3% for those with and without ARF, respectively (HR 1.3, 95%
CI 1.2 to 1.5). The mortality was higher in patients with an increased severity
of renal failure.
Conclusions:
ARF is a common complication of surgery in elderly patients who
sustain a fracture of the hip, and is associated with increased mortality up to
one year after surgery despite adjustment for coexisting comorbidity and medi-
cation before surgery. Even small change in renal function within five days of
surgery for a fracture of the hip has substantial implication on mortality up to
one year post- operatively.
No conflicts of interest reported
105.