Preoperative and intraoperative risk factors for acute kidney injury after hip fracture surgery: a cohort retrospective study
Bassem I. Haddad, Abdulrahman Ahmad Alhajahjeh, Abdelrahman Altarazi, Layla El-Amayreh, Mohammad Hamdan, Batool AlQuabeh, Waid Abd Ul Ghani, Randa Farah
Abstract
Introduction Hip fractures have several adverse effects on patients’ morbidity and mortality. Postoperative Acute kidney injury (AKI) is one of the complications that have a significant impact on the patient’s overall prognosis. We aimed to identify AKI risk after hip fracture surgery and the preoperative and intraoperative risk factors.Methodology We conducted a retrospective cohort study in a tertiary care hospital on adult patients who underwent surgery for hip fractures between January 2015 and August 2021. All clinical data were reviewed.Result A total of 611 patients were included (age = 76.44 ± 9.69 years). 126 (20.6%) of them developed AKI postoperatively. In multilinear logistic regression analysis, factors associated with postoperative AKI included eGFR [odds ratio (OR): 0.98; 95% confidence interval (CI): 0.97–0.99 with a p value .01], spinal anesthesia [OR: 1.78; 95% CI: 1.1–2.9 with a p value .01], and partial hip replacement (PHR) type of surgery [OR: 0.56; 95% CI: 0.32–0.96 with a p value .036]. The development of postoperative AKI was the strongest factor that increase mortality of the patients as the (HR = 2.42, CI 95% [1.57–3.74]; p value <.001).Conclusion In this study, we highlight that lower eGFR, and spinal anesthesia were associated with a higher risk of AKI, and PHR surgery has lower odds to develop AKI. Postoperative AKI is associated with a higher mortality rate after hip fracture surgery.