Background: Patients with preoperative acute heart failure (AHF) after hip fracture in the elderly have a worse prognosis. We aim to investigate the characteristics, risk factors and postoperative complications of elderly patients with hip fracture complicated with preoperative AHF. We also looked at the effect of the severity of anemia at admission on the prognosis of the above people.
Methods: A retrospective study of hip fracture patients (aged ≥ 65) admitted to the Department of Geriatric Orthopaedics, Third Hospital, Hebei Medical University, was conducted from January 2018 to October 2020. We used univariate and multivariate logistic regression to assess risk factors for preoperative AHF. The Kaplan-Meier survival curve shows the relationship between the severity of anemia on admission and all-cause mortality in elderly hip fracture patients with preoperative AHF.
Results: Out of the 1092 patients, 503 had preoperative AHF and the incidence of it in hip fracture patients was 46.1%. Age, coronary artery disease, chronic atrial fibrillation, Age-Adjusted Charlson Comorbidity Index (ACCI), admission anemia, admission albumin < 40 g/dl, and admission C-reactive protein (CRP) were all significantly different between those with AHF and those without. Multivariate logistic regression analysis revealed that age ≥ 80 years (OR 1.740, 95% CI 1.309-2.313), coronary artery disease (OR 1.417, 95% CI 1.017-1.975), chronic atrial fibrillation (OR 4.010, 95% CI 1.757-9.152), admission anemia (OR 1.433, 95% CI 1.051-1.953) are the independent risk factors for preoperative AHF in elderly patients with hip fracture (p < 0.05). The HF group exhibited a higher incidence of postoperative complications, such as anemia, arrhythmia, NOAF (new-onset atrial fibrillation), AIS (acute ischemic stroke), electrolyte disturbance and hypoproteinemia. The moderate-to-severe anemia group had a higher incidence of postoperative complications, including deep vein thrombosis of the lower limbs, NOAF, and hypoproteinemia, as well as all-cause mortality.
Conclusion: Older patients combined with admission anemia, coronary artery disease, chronic atrial fibrillation are more likely to have preoperative AHF after hip fracture. For such patients, early and effective identification and strengthening perioperative management can avoid the occurrence of adverse events. For patients with moderate and severe anemia at admission, timely intervention is recommended to reduce postoperative complications and mortality.
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http://dx.doi.org/10.1186/s12891-024-08252-w | DOI Listing |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694428 | PMC |
BMC Geriatr
January 2025
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139, ZiQiang Lu, Shijiazhuang, Hebei, 050051, PR China.
Background: A scarcity of data exists concerning atrial fibrillation (AF) during the perioperative stage of non-cardiothoracic surgery, particularly orthopedic surgery. In addition, given the frequency and significant impact of AF in the perioperative period, therefore our aim was to identify prognosis and predictors of elderly hip fracture patients with perioperative AF.
Methods: An examination of hip fracture patients at the Third Hospital of Hebei Medical University, who had been hospitalized from January 2018 to October 2020 in succession, was conducted retrospectively.
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January 2025
Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
Rett syndrome (RS) is a rare neurodevelopmental disorder primarily caused by mutations in the X-linked methyl-CpG binding protein 2 (MECP2) gene, responsible for encoding MECP2 which plays a pivotal role in regulating gene expression. The neurological and non-neurological manifestations of RS vary widely in severity depending on the specific mutation type. Bone complications, mostly scoliosis but also osteoporosis, hip displacement, and a high rate of fractures, are among the most prevalent non-neurological comorbidities observed in girls with RS.
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January 2025
Internal Medicine Division, Federal University of Parana (UFPR), Curitiba, PR, Brazil.
Patients with radiographic axial spondyloarthritis (r-axSpA) experience a higher prevalence of fragility fractures, though the pathophysiology of osteoporosis associated with this disease remains poorly understood. The objective of this study was to evaluate the histomorphometric data in r-axSpA patients. Male r-axSpA patients up to 55 years old were enrolled in this cross-sectional study.
View Article and Find Full Text PDFMol Med Rep
March 2025
Department of Orthopedics, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, P.R. China.
Aseptic loosening (AL) of artificial hip joints is the most common complication following hip replacement surgery. A total of eight patients diagnosed with AL following total hip arthroplasty (THA) undergoing total hip replacement and eight control patients diagnosed with avascular necrosis of femoral head (ANFH) or femoral neck fracture undergoing THA were enrolled. The samples of the AL group were from synovial tissue surrounding the lining/head/neck of the prosthesis, and the samples of the control group were from the synovium in the joint cavity.
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