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Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures

INTRODUCTION: Intertrochanteric hip fractures are a common injury treated by orthopedic surgeons and the incidence rate is rising. Preoperative depression is a known risk factor for postoperative complications in orthopaedic surgery, however its effects on outcomes after geriatric hip fractures is r...

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Autores principales: Broggi, Matthew S., Oladeji, Philip O., Tahmid, Syed, Hernandez-Irizarry, Roberto, Allen, Jerad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155747/
https://www.ncbi.nlm.nih.gov/pubmed/34104531
http://dx.doi.org/10.1177/21514593211016252
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author Broggi, Matthew S.
Oladeji, Philip O.
Tahmid, Syed
Hernandez-Irizarry, Roberto
Allen, Jerad
author_facet Broggi, Matthew S.
Oladeji, Philip O.
Tahmid, Syed
Hernandez-Irizarry, Roberto
Allen, Jerad
author_sort Broggi, Matthew S.
collection PubMed
description INTRODUCTION: Intertrochanteric hip fractures are a common injury treated by orthopedic surgeons and the incidence rate is rising. Preoperative depression is a known risk factor for postoperative complications in orthopaedic surgery, however its effects on outcomes after geriatric hip fractures is relatively unknown. The purpose of this study was to investigate the relationship between preoperative depression and potential complications following open reduction internal fixation (ORIF) and intramedullary nailing (IMN) of geriatric hip fractures. METHODS: In this retrospective study, the Truven Marketscan claims database was used to identify patients over age 65 who underwent ORIF or IMN for a hip fracture from January 2009 to December 2019. Patient characteristics, such as medical comorbidities, were collected and from that 2 cohorts were established (one with and one without depression). Chi-squared and multivariate analysis was performed to investigate the association between preoperative depression and common postoperative complications following intertrochanteric hip fracture surgery. RESULTS: In total, 78,435 patients were identified for analysis. In those patients with preoperative depression, the complications associated with the greatest increased odds after undergoing ORIF were surgical site infections (OR 1.32; CI 1.23-1.44), ED visit for pain (OR 1.27; CI 1.16-1.39), wound complications (OR 1.26; CI 1.14-1.35), and non-union (OR 1.25; CI 1.17-1.33). In the patients with preoperative depression undergoing IMN, the complications associated with the greatest increased odds after were surgical site infections (OR 1.37; CI 1.31- 1.45), ED visit for pain (OR 1.31; CI 1.19-1.44), wound complications (OR 1.23; CI 1.10-1.39), and pneumonia (OR 1.22; CI 1.10-1.31). CONCLUSIONS: Preoperative depression in patients undergoing hip fracture surgery is associated with increased complications. Recognizing a patients’ preoperative depression diagnosis can allow physicians to adapt perioperative and postoperative surveillance protocols for these higher risk patients. Further studies are warranted to investigate the degree to which depression is a modifiable risk factor
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spelling pubmed-81557472021-06-07 Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures Broggi, Matthew S. Oladeji, Philip O. Tahmid, Syed Hernandez-Irizarry, Roberto Allen, Jerad Geriatr Orthop Surg Rehabil Resident Corner INTRODUCTION: Intertrochanteric hip fractures are a common injury treated by orthopedic surgeons and the incidence rate is rising. Preoperative depression is a known risk factor for postoperative complications in orthopaedic surgery, however its effects on outcomes after geriatric hip fractures is relatively unknown. The purpose of this study was to investigate the relationship between preoperative depression and potential complications following open reduction internal fixation (ORIF) and intramedullary nailing (IMN) of geriatric hip fractures. METHODS: In this retrospective study, the Truven Marketscan claims database was used to identify patients over age 65 who underwent ORIF or IMN for a hip fracture from January 2009 to December 2019. Patient characteristics, such as medical comorbidities, were collected and from that 2 cohorts were established (one with and one without depression). Chi-squared and multivariate analysis was performed to investigate the association between preoperative depression and common postoperative complications following intertrochanteric hip fracture surgery. RESULTS: In total, 78,435 patients were identified for analysis. In those patients with preoperative depression, the complications associated with the greatest increased odds after undergoing ORIF were surgical site infections (OR 1.32; CI 1.23-1.44), ED visit for pain (OR 1.27; CI 1.16-1.39), wound complications (OR 1.26; CI 1.14-1.35), and non-union (OR 1.25; CI 1.17-1.33). In the patients with preoperative depression undergoing IMN, the complications associated with the greatest increased odds after were surgical site infections (OR 1.37; CI 1.31- 1.45), ED visit for pain (OR 1.31; CI 1.19-1.44), wound complications (OR 1.23; CI 1.10-1.39), and pneumonia (OR 1.22; CI 1.10-1.31). CONCLUSIONS: Preoperative depression in patients undergoing hip fracture surgery is associated with increased complications. Recognizing a patients’ preoperative depression diagnosis can allow physicians to adapt perioperative and postoperative surveillance protocols for these higher risk patients. Further studies are warranted to investigate the degree to which depression is a modifiable risk factor SAGE Publications 2021-05-25 /pmc/articles/PMC8155747/ /pubmed/34104531 http://dx.doi.org/10.1177/21514593211016252 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial 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
Broggi, Matthew S.
Oladeji, Philip O.
Tahmid, Syed
Hernandez-Irizarry, Roberto
Allen, Jerad
Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures
title Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures
title_full Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures
title_fullStr Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures
title_full_unstemmed Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures
title_short Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures
title_sort depressive disorders lead to increased complications after geriatric hip fractures
topic Resident Corner
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155747/
https://www.ncbi.nlm.nih.gov/pubmed/34104531
http://dx.doi.org/10.1177/21514593211016252
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