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J Korean Soc Emerg Med > Volume 33(6); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(6): 581-588.
수술을 시행 받은 노인 고관절 골절 환자에서 합병증 발생의 예측인자
장경덕 , 이재백 , 진영호 , 정태오 , 윤재철 , 오태환 , 김소은
전북대학교병원 응급의학과
The predictive factors in the emergency department associated with medical complications in older hip fracture patients underwent surgery
Kyoung Deok Jang , Jae Baek Lee , Young Ho Jin , Tae Oh Jeong , Jae Chol Yoon , Tae Hwan Oh , So Eun Kim
Department of Emergency Medicine, Jeonbuk National University Hospital, Jeonju, Korea
Correspondence  So Eun Kim ,Tel: 063-250-1075, Fax: 063-250-1075, Email: funny8303@naver.com,
Received: November 10, 2021; Revised: November 16, 2021   Accepted: November 19, 2021.  Published online: December 31, 2022.
ABSTRACT
Objective:
Hip fractures in elderly populations are a major public concern worldwide. This study aims to demonstrate the emergency department (ED)-related factors associated with medical complications in older patients with hip fractures who underwent surgery.
Method:
This was a retrospective observational study of 150 elderly patients (≥65 years) presenting with hip fractures in 2020. The data collected were analyzed to investigate medical complications and determine the predictors of complications after a hip fracture surgery by comparing the complication and non-complication group patients. Logistic regression analysis was applied to determine the independent predictors of postoperative medical complications.
Results:
The overall complication rate was determined to be 39.3%, and delirium (40.7%) was observed to be the most common affliction. Independent walking (adjusted odds ratio [AOR], 0.459; 95% confidence interval [CI], 0.214-0.985), pre-operative medical conditions (AOR, 4.823; 95% CI, 1.735-13.408), and estimated glomerular filtration rate (eGFR; 3rd quartile [AOR, 3.224; 95% CI, 1.086-9.576], 4th quartile [AOR, 5.584; 95% CI, 1.861-16.756]) were independently associated with the development of medical complications post-surgery.
Conclusion:
The overall incidence of complications following hip fracture surgery is relatively high. Independent walking, preoperative medical condition, and decreased eGFR are independent predictors of postoperative complications that can be screened in the ED in elderly hip fracture patients.
Key words: hip fracture, complication, risk factor, emergency department
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