, Volume 471, Issue 12, pp 3795-3802
Date: 18 Jun 2013

Which Patients Are at Risk for Kidney Dysfunction After Hip Fracture Surgery?

Topic
Hip

Abstract

Background

Kidney dysfunction (KD) after hip fracture surgery is a major complication. However, the incidence and risk factors of KD in this population are unclear.

Questions/purposes

We therefore (1) determined the incidence of KD in a large cohort of fracture patients, (2) identified preoperative risk factors predisposing to KD, and (3) determined the effect of KD on length of stay and subsequent function.

Methods

Between April 2011 and June 2012, 450 patients (263 women) with a mean age of 73 years (range, 67–96 years) underwent surgery for hip fracture in our institution. We calculated incidence and retrospectively reviewed suspected predisposing risk factors. We report followup at 6 months.

Results

The overall incidence of KD was 11% (n = 52). Forty-five patients (86%) developed acute KD and seven patients developed acute-on-chronic KD. Three of the 52 patients died during the followup time. Thirty-eight of the 52 patients (73%) regained their prior kidney function after treatment. An increased risk of KD was found in those with diabetes, shock during or after surgery, age, and preexisting KD. Mean length of stay was higher for patients with KD compared to those without: 9.6 versus 7.4, respectively. At 6 months, 39 of the 49 surviving patients (80%) were fully weightbearing.

Conclusions

Many patients at risk for postoperative KD can be identified and treated. Most patients recover from their KD and the majority return to full weightbearing.

Level of Evidence

Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
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Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This work was performed at KAT Hospital, Athens, Hellas.