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Perioperative administration of methylprednisolone was associated with postoperative pulmonary complications in elderly patients undergoing hip fracture surgery

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Abstract

Background

Postoperative pulmonary complications (PPCs) seriously affect the postoperative prognosis of elderly patients underwent hip fracture surgery. Although methylprednisolone is increasingly used, the association between perioperative methylprednisolone and PPCs is still controversial. The study aims to determine whether perioperative administration of methylprednisolone is associated with PPCs in elderly patients during hip fracture surgery.

Patients and Methods

In this retrospective cohort study, records of 584 patients (≥ 65 years) who underwent hip fracture surgery between January 2013 and October 2020 were extracted. Univariate and multivariate regression analysis were performed to identify the risk factors for PPCs. To further explore the association between administration of methylprednisolone and PPCs, 53 patients received methylprednisolone and 53 patients without methylprednisolone were matched for the confounding factors using propensity score matching (PSM) analysis. The odds ratios (OR) and 95% confidence intervals (CI) for the above variables were analyzed.

Results

The incidence of PPCs during postoperative hospitalization was 6.83% (38/556) among the elderly patients following hip fracture surgery. Patients with PPCs had higher postoperative mortality rate, longer hospital stay, more hospitalization cost, and higher incidence of cardiac arrest (all P < 0.05). Multivariate logistic regression analysis showed that age, hypertension, hypoglycemia, hypoproteinemia and perioperative methylprednisolone were independent risk factors for PPCs. Moreover, administration of methylprednisolone was significantly correlated with PPCs both before PSM adjustment (OR = 3.25; 95% CI, 1.67 to 6.33; P = 0.001) and after PSM adjustment (OR = 6.68; 95% CI, 1.40 to 31.82; P = 0.017).

Conclusion

Perioperative administration of methylprednisolone is a risk factor for PPCs in elderly patients undergoing hip fracture surgery.

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Funding

This study was supported partly by the National Natural Science Foundation of China (Grant No. 82102297 and 81974296), Basic and Applied Basic Research Foundation of Guangdong Province (Grant No. 2019A1515110020) and Natural Science Foundation of Guangdong Province (Grant No. 2018A0303130224 and 2022A1515012603).

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Author notes

  1. Jun Zhou, Chaojin Chen and Nan Cheng have contributed equally to the work.

Authors and Affiliations

  1. Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, China

    Jun Zhou, Chaojin Chen, Nan Cheng, Jibin Xing, Lusi Li, Ziqing Hei & Shaoli Zhou

  2. Guangzhou AID Cloud Technology Co., LTD, Guangzhou, 510000, China

    Rongchang Guo & Dong Yang

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  1. Jun Zhou
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Correspondence to Chaojin Chen, Ziqing Hei or Shaoli Zhou.

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Ethics Approval

The present study was conducted in accordance with the Declaration of Helsinki and the protocol was approved by the Ethics Committee of our hospital on 14 May 2019 (No.[2019]02–609-02). The requirement for informed consent and clinical trial registration were waived by the committee.

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The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Zhou, J., Chen, C., Cheng, N. et al. Perioperative administration of methylprednisolone was associated with postoperative pulmonary complications in elderly patients undergoing hip fracture surgery. Aging Clin Exp Res 34, 2005–2012 (2022). https://doi.org/10.1007/s40520-022-02166-0

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  • DOI: https://doi.org/10.1007/s40520-022-02166-0

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