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Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients
INTRODUCTION: Pneumonia, thromboembolic and ischemic events, urinary tract infections (UTI), delirium and acute kidney injury (AKI) are common complications during the treatment of fragility fractures. In a 2 years-follow-up we determined the according incidence and risk factors of these and other c...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961710/ https://www.ncbi.nlm.nih.gov/pubmed/33786204 http://dx.doi.org/10.1177/2151459321998314 |
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author | Wiedl, Andreas Förch, Stefan Fenwick, Annabel Mayr, Edgar |
author_facet | Wiedl, Andreas Förch, Stefan Fenwick, Annabel Mayr, Edgar |
author_sort | Wiedl, Andreas |
collection | PubMed |
description | INTRODUCTION: Pneumonia, thromboembolic and ischemic events, urinary tract infections (UTI), delirium and acute kidney injury (AKI) are common complications during the treatment of fragility fractures. In a 2 years-follow-up we determined the according incidence and risk factors of these and other complications in orthogeriatric inward patients, as well as the respective associated mortality. METHODS: All patients treated on an orthogeriatric co-managed ward over the course of a year were included. Besides injury, therapy and geriatric assessment parameters, we evaluated the inward incidence of common complications. In a 2 years-follow-up the associated death rates were aquired. SPSS (IBM) was used to determine the importance of risk factors predisposing to the respective occurrence of a complication and accordingly determine it’s impact on the patients’ 1- and 2-years-mortality. RESULTS: 830 orthogeriatric patients were initially assessed with a remaining follow-up cohort of 661 (79.6%). We observed very few cases of thrombosis (0.6%), pulmonary embolism (0.5%), apoplex (0.5%) and myocardial infarction (0.8%). Pneumonia was seen in 42 (5.1%), UTI in 85 (10.2%), delirium in 186 (22.4%) and AKI in 91 (11.0%) patients. Consistently ADL on admission was found to be a relevant risk factor in the development of each complication. After adjustment only AKI showed a significant increased mortality risk of 1.60 (95%CI:1.086-2.350). DISCUSSION: In our fracture-independent assessment of complications in the orthogeriatric treatment of inward patients we’ve seen very rare cases of cardiac and thrombotic complications. Typical fragility-fracture associated common events like pneumonia, UTI, delirium and AKI were still more incidental. No complication except AKI was associated to significant increased mortality risk. CONCLUSIONS: The relevance of orthogeriatric care in prevention and outcome of inward complications seems promising, needing still more controlled studies, evaluating not just hip fracture patients but more diverse groups. Consensus is needed in the scholar evaluation of orthogeriatric complications. |
format | Online Article Text |
id | pubmed-7961710 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-79617102021-03-29 Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients Wiedl, Andreas Förch, Stefan Fenwick, Annabel Mayr, Edgar Geriatr Orthop Surg Rehabil Resident Corner INTRODUCTION: Pneumonia, thromboembolic and ischemic events, urinary tract infections (UTI), delirium and acute kidney injury (AKI) are common complications during the treatment of fragility fractures. In a 2 years-follow-up we determined the according incidence and risk factors of these and other complications in orthogeriatric inward patients, as well as the respective associated mortality. METHODS: All patients treated on an orthogeriatric co-managed ward over the course of a year were included. Besides injury, therapy and geriatric assessment parameters, we evaluated the inward incidence of common complications. In a 2 years-follow-up the associated death rates were aquired. SPSS (IBM) was used to determine the importance of risk factors predisposing to the respective occurrence of a complication and accordingly determine it’s impact on the patients’ 1- and 2-years-mortality. RESULTS: 830 orthogeriatric patients were initially assessed with a remaining follow-up cohort of 661 (79.6%). We observed very few cases of thrombosis (0.6%), pulmonary embolism (0.5%), apoplex (0.5%) and myocardial infarction (0.8%). Pneumonia was seen in 42 (5.1%), UTI in 85 (10.2%), delirium in 186 (22.4%) and AKI in 91 (11.0%) patients. Consistently ADL on admission was found to be a relevant risk factor in the development of each complication. After adjustment only AKI showed a significant increased mortality risk of 1.60 (95%CI:1.086-2.350). DISCUSSION: In our fracture-independent assessment of complications in the orthogeriatric treatment of inward patients we’ve seen very rare cases of cardiac and thrombotic complications. Typical fragility-fracture associated common events like pneumonia, UTI, delirium and AKI were still more incidental. No complication except AKI was associated to significant increased mortality risk. CONCLUSIONS: The relevance of orthogeriatric care in prevention and outcome of inward complications seems promising, needing still more controlled studies, evaluating not just hip fracture patients but more diverse groups. Consensus is needed in the scholar evaluation of orthogeriatric complications. SAGE Publications 2021-03-11 /pmc/articles/PMC7961710/ /pubmed/33786204 http://dx.doi.org/10.1177/2151459321998314 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Resident Corner Wiedl, Andreas Förch, Stefan Fenwick, Annabel Mayr, Edgar Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients |
title | Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients |
title_full | Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients |
title_fullStr | Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients |
title_full_unstemmed | Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients |
title_short | Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients |
title_sort | incidence, risk-factors and associated mortality of complications in orthogeriatric co-managed inpatients |
topic | Resident Corner |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961710/ https://www.ncbi.nlm.nih.gov/pubmed/33786204 http://dx.doi.org/10.1177/2151459321998314 |
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