Predictors of one-year postoperative complications in geriatric patients with hip fracture: A retrospective cohort study at a tertiary care centre

BACKGROUND: Hip fracture (HF) commonly occurs in persons of older age following a fall or an accident or in association with osteoporosis and increases the risk of chronic illnesses and mortality. Specifically, HF complications might develop during admission or postsurgically following discharge. The aim of this study was to investigate the prevalence and predictors of one-year postoperative complications in geriatric patients with HF. METHODS: A retrospective study was conducted using data from the electronic medical records of Thai patients age 60 years and over with HFs who underwent HF surgery and were admitted to an orthopaedic ward between January 2019 and December 2022. Data were collected using a case report form detailing patient characteristics, including baseline demographics, clinical characteristics, and one-year postoperative complications. Data were analysed using descriptive statistics, Pearson's chi-square test and logistic regression. RESULTS: Participants were 376 Thai adults ages 60-99 (mean age 80 years). Within one year after HF surgery, 33.5% of the patients developed the following major clinical complications: urinary tract infection (25.2%), pneumonia (10.6%), pulmonary embolism (1.6%), deep vein thrombosis (0.8%), surgical site infection (0.8%) and hip dislocation (0.3%). The strongest predictors of postoperative complications were American Society of Anesthesiologists classification (p < 0.001), length of stay (p < 0.001) and nutritional status (p = 0.001). CONCLUSION: This study provides helpful information for clinicians dealing with geriatric patients with HF, including the prevalence of one-year postoperative complications, while also identifying predictors of postoperative complications.