Abstract
Abstract
Introduction:
Hip fractures are a common injury associated with significant morbidity and mortality. In the United States, there has been a rapid increase in the prevalence of metabolic syndrome (MetS), a condition comprised several common comorbidities, including obesity, diabetes mellitus, and hypertension, that may worsen perioperative outcomes. This article assesses the impact of MetS and its components on outcomes after hip fracture surgery.
Methods:
Patients who underwent nonelective operative treatment for traumatic hip fractures were identified in the 2015–2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Baseline characteristics between groups were compared, and significant differences were included as covariates. Multivariate regression was performed to assess the impact of characteristics of interest on postoperative outcomes. Patients with MetS, or a single one of its constitutive components—hypertension, diabetes, and obesity—were compared with metabolically healthy cohorts.
Results:
In total 95,338 patients were included. Patients with MetS had increased complications (OR 1.509; P < 0.001), but reduced mortality (OR 0.71; P < 0.001). Obesity alone was also associated with increased complications (OR 1.14; P < 0.001) and reduced mortality (OR 0.736; P < 0.001). Both hypertension and diabetes alone increased complications (P < 0.001) but had no impact on mortality. Patients with MetS did, however, have greater odds of adverse discharge (OR 1.516; P < 0.001), extended hospital stays (OR 1.18; P < 0.001), and reoperation (OR 1.297; P = 0.003), but no significant difference in readmission rate.
Conclusion:
Patients with MetS had increased complications but decreased mortality. Our component-based analysis showed had obesity had a similar effect: increased complications but lower mortality. These results may help surgeons preoperatively counsel patients with hip fracture about their postoperative risks.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference58 articles.
1. The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen;Cummings;Clin Orthop Relat Res,1990
2. Falls: epidemiology, pathophysiology, and relationship to fracture;Berry;Curr Osteoporos Rep,2008
3. Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients;Parkkari;Calcif Tissue Int,1999
4. The aftermath of hip fracture: discharge placement, functional status change, and mortality;Bentler;Am J Epidemiol,2009
5. The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study;Wolinsky;Am J Public Health,1997