Journal of General Internal Medicine

, Volume 21, Issue 3, pp 219–225 | Cite as

Preoperative status and risk of complications in patients with hip fracture

  • Mary Ann McLaughlin
  • Gretchen M. Orosz
  • Jay Magaziner
  • Edward L. Hannan
  • Thomas McGinn
  • R. Sean Morrison
  • Tsivia Hochman
  • Kenneth Koval
  • Marvin Gilbert
  • Albert L. Siu
Original Articles

Abstract

BACKGROUND: Limited information is available on preoperative status and risks for complications for older patients having surgery for hip fracture. Our objective was to identify potentially modifiable clinical findings that should be considered in decisions about the timing of surgery.

METHODS: We conducted a prospective cohort study with data obtained from medical records and through structured interviews with patients. A total of 571 adults with hip fracture who were admitted to 4 metropolitan hospitals were included.

RESULTS: Multiple logistic regression was used to identify risk factors (including 11 categories of physical and laboratory findings, classified as mild and severe abnormalities) for in-hospital complications. The presence of more than 1 (odds ratiol [OR] 9.7, 95% confidence interval [CI] 2.8 to 33.0) major abnormality before surgery or the presence of major abnormalities on admission that were not corrected prior to surgery (OR 2.8, 95% CI 1.2 to 6.4) was independently associated with the development of postoperative complications. We also found that minor abnormalities, while warranting correction, did not increase risk (OR 0.70, 95% CI 0.28 to 1.73).

CONCLUSIONS: In this study of older adults undergoing urgent surgery, potentially reversible abnormalities in laboratory and physical examination occurred frequently and significantly increased the risk of postoperative complications. Major clinical abnormalities should be corrected prior to surgery, but patients with minor abnormalities may proceed to surgery with attention to these medical problems perioperatively.

Key words

preoperative assessment complications elderly noncardiac surgery hip fracture 

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Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  • Mary Ann McLaughlin
    • 1
    • 2
  • Gretchen M. Orosz
    • 3
  • Jay Magaziner
    • 4
  • Edward L. Hannan
    • 5
  • Thomas McGinn
    • 1
  • R. Sean Morrison
    • 1
    • 2
  • Tsivia Hochman
    • 1
    • 2
  • Kenneth Koval
    • 6
  • Marvin Gilbert
    • 1
  • Albert L. Siu
    • 1
    • 2
  1. 1.Mount Sinai Medical CenterNew York
  2. 2.Bronx Veterans Affairs Medical CenterBronxUSA
  3. 3.University of Arkansas for Medical ScienceFort SmithUSA
  4. 4.School of MedicineUniversity of MarylandBaltimoreUSA
  5. 5.State University of New York, University at Albany School of Public HealthAlbanyUSA
  6. 6.Hospital for Joint DiseasesNew YorkUSA

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