Hypertension-related target organ damage nearly doubled mortality risk (HR 1.98) in elderly patients after proximal femoral fracture surgery compared to uncomplicated hypertension.
Does the presence of hypertension-related target organ complications increase postoperative mortality in elderly patients undergoing surgery for proximal femoral fractures?
In elderly patients undergoing surgery for proximal femoral fractures, the presence of hypertension-related target organ damage significantly increases the risk of postoperative mortality.
Absolute Event Rate: 0% vs 0%
Introduction. Arterial hypertension (HTN) is a common chronic condition in elderly individuals and an important risk factor for target organ damage, which may adversely affect perioperative outcomes. Proximal femoral fractures (PFFs) are associated with high postoperative mortality; however, the prognostic significance of hypertension-related organ complications in this patient population remains insufficiently defined. This study aimed to assess the impact of HTN and its target organ complications on mortality in patients undergoing surgery for low-energy PFF. Materials and methods. A retrospective analysis was conducted in 74 patients aged ≥65 years with diagnosed HTN who underwent surgical treatment for low-energy PFF between March 2020 and March 2021. Among them, 38 patients (51.4%) had uncomplicated HTN, while 36 patients (48.6%) had complicated HTN, including cardiovascular, cerebrovascular, renal, or mixed complications. Postoperative mortality was analyzed. Survival was assessed using the Kaplan–Meier method, and the effect of hypertension-related complications on the risk of death was evaluated using the Cox proportional hazards model.Results. Patients with complicated HTN exhibited significantly higher mortality compared with those with uncomplicated HTN. Kaplan–Meier survival analysis demonstrated significant differences between the survival curves of both groups (log-rank p < 0.05). The presence of hypertension-related target organ damage was associated with an almost twofold increase in the risk of death (HR = 1.98; 95% CI: 1.09–3.59; p < 0.05). The poorest prognosis was observed in patients with mixed complications, particularly those involving both the cardiovascular system and the kidneys. Conclusions. The presence of target organ complications of HTN is a key determinant of mortality in patients undergoing surgery for PFF. The worst prognosis is observed in patients with mixed complications, particularly those affecting both the cardiovascular system and the kidneys. The impact of complicated HTN on survival is long-lasting. It is not limited to the early postoperative period, supporting its role as a significant risk marker in this patient population.
Rzepecki et al. (Sun,) reported a other. Hypertension-related target organ damage nearly doubled mortality risk (HR 1.98) in elderly patients after proximal femoral fracture surgery compared to uncomplicated hypertension.