Key result
Early postoperative hypoalbuminemia linked to ~18-fold greater AKI risk in elderly femoral neck fracture patients.
Why the study?
Postoperative AKI is not unusual and is linked with significant morbidity and mortality, prompting investigation into its incidence and risk factors in elderly patients undergoing surgery for femoral neck fracture.
Case-Control (n=308)
No
Odds Ratio: 17.94
p-value: p=<0.01
Early postoperative albumin, perioperative average hemoglobin, and intraoperative hypotension are independent risk factors for postoperative AKI in elderly patients undergoing femoral neck fracture surgery.
Hypoalbuminemia was associated with higher postoperative AKI risk after elderly femoral neck fracture surgery; hypothesis-generating and should not yet change practice.
Background: Hip fracture is highly associated with disability and consequently mortality in the elderly population. Postoperative acute kidney injury (AKI) is not unusual and is associated with considerable morbidity and mortality. We aimed to determining the incidence and potential risk factors for postoperative AKI in elderly patients with femoral neck fracture.Methods: We retrospectively evaluated patients over 65 years of age who had been subjected to surgery for femoral neck fracture at Peking University People's Hospital from January 2015 to December 2019. Demographic characteristics and potential risk factors were collected. AKI was defined according to the Kidney Disease Improving Global Outcomes guidelines.Results: A total of 308 elderly patients with femoral neck fracture were included in the study. The overall incidence of postoperative AKI was 12% (37 cases). Through binary logistic regression analysis, adjusted for age, intraoperative blood loss and BMI, we identified that early postoperative albumin, perioperative average hemoglobin and intraoperative hypotension are independent risk factors for postoperative AKI. The model considering the three factors can improve accuracy of predicting the possibility of developing AKI.Conclusion: The incidence of postoperative AKI in elderly patients with femoral neck fracture was 12%. Independent risk factors included early postoperative albumin, perioperative average hemoglobin and intraoperative hypotension. Taking multiple possible factors into consideration can better predict the possibility of developing AKI after surgery for elderly patients.
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Zhan et al. (2021) conducted a case-control in Femoral neck fracture (n=308). Early postoperative hypoalbuminemia (<29.6 g/L) vs. Postoperative albumin ≥29.6 g/L was evaluated on Postoperative acute kidney injury (AKI) (OR 17.94, p=<0.01). Early postoperative hypoalbuminemia (<29.6 g/L) significantly increased the risk of postoperative acute kidney injury (OR 17.94) in elderly patients undergoing surgery for femoral neck fractures.
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