Risk factors for hospital-acquired pneumonia in hip fracture patients: A systematic review and meta-analysis
Abstract
Background: This study aimed to comprehensively assess the prevalence and risk factors for Hospital-acquired pneumonia (HAP) in hip fracture patients by meta-analysis. Methods: Systematically searched 4 English databases and 4 Chinese databases from inception until October 20, 2022. All studies involving risk factors of HAP in patients with hip fractures will be considered. Newcastle-Ottawa Scale was used to evaluate the quality of the included studies. The results were presented through Review Manager 5.4 with the pooled odds ratio (OR) and 95% confidence interval. Results: Of 35 articles included in this study, the incidence of HAP was 8.9%. 43 risk factors for HAP were initially included, 23 were eventually involved in the meta-analysis, and 21 risk factors were significant. Among them, the 4 most frequently mentioned risk factors were as follows: Advanced age (OR 1.07, 95% CI 1.05–1.10), chronic obstructive pulmonary disease (COPD) (OR 3.44, 95% CI 2.83–4.19), time from injury to operation (OR 1.09, 95% CI 1.07–1.12), time from injury to operation ≥ 48 hours (OR 3.59, 95% CI 2.88–4.48), and hypoalbuminemia < 3.5g/dL (OR 2.68, 95% CI 2.15–3.36). Discussion: Hip fracture patients diagnosed with COPD have a 3.44 times higher risk of HAP compared to the general hip fracture patients. The risk of HAP also increases with age, with patients over 70 having a 2.34-fold higher risk and those over 80 having a 2.98-fold higher risk. These findings highlight the need for tailored…
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