Prognostic Implications of Preoperative Pneumonia for Geriatric Patients Undergoing Hip Fracture Surgery or Arthroplasty
Abstract
Objective To report outcomes of geriatric patients undergoing hip fracture surgery or arthroplasty with or without preoperative pneumonia and to evaluate the influence of pneumonia severity on patient prognosis. Methods In this single center retrospective study, we included geriatric patients (≥60 years old) who had undergone hip fracture surgery or arthroplasty at Peking University People's Hospital from January 2008 to September 2018. Patients with fractures caused by neoplasms or patients with incomplete clinical data were excluded. Using logistic regression and the CURB‐65 (confusion, uremia, respiratory rate, blood pressure, and age ≥65 years) score as a prediction tool of 1‐year mortality, the effect of preoperative pneumonia on 1‐year mortality was evaluated. Survival of patients with different response to pneumonia‐specific therapy and survival of patients with different pneumonia severity (evaluated with CURB‐65 score) were analyzed using Cox regression. Results A total of 1386 patients were included; among them, 109 patients (7.86%) were diagnosed with preoperative pneumonia. Outcomes were evaluated in August 2019 (at least 1 year after surgery for all patients). Compared to patients without preoperative pneumonia, patients with this condition had higher 30‐day mortality (11.9% vs 5%, P = 0.002) and 1‐year mortality rates (33.9% vs 16.3%, P < 0.001) and higher incidence of acute heart failure (7.3% vs 3.4%, P = 0.034) and acute kidney injury (5.5% vs 1.8%, P =…
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