Clinical Outcomes and Surgical Complications Among Patients with Bleeding Disorders After Acute Hip Fracture Surgery. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Darbandi, Aria D.; Saadat, Ghulam H.; Butler, Bennet A.; Bokhari, Faran
• Is Part Of: Journal of orthopaedic trauma. Volume 36:Issue 2(2022)
• Publication Date: 2022-02
• Subjects: hip fracture -- bleeding disorders -- complications; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002212
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objective: To compare short-term (⩽30 days) outcomes of hip fracture between patients with and without bleeding disorders. Design: Retrospective database review. Setting: The study setting included hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program database. Patients: Patients with acute hip fractures were identified from the National Surgical Quality Improvement Program database between 2016 and 2019. Intervention: Open reduction internal fixation or hemiarthroplasty. Main Outcome Measurements: Mortality, readmission, reoperation, length of stay, and complication were main outcome measurements. Results: There were 63, 718 patients undergoing hip surgery, and 16.0% had a bleeding disorder. After adjusting for confounders, multivariable regression models showed that cases with bleeding disorders were associated with higher rates of transfusion [odds ratio (OR) 1.404; confidence interval (CI), 1.335–1.479], myocardial infarction (OR 1.367; CI, 1.190–1.572), pneumonia (OR 1.193; CI, 1.078–1.321), renal failure (OR 1.843; CI, 1.363–2.491), surgical site infections (OR 1.429; CI, 1.185–1.175), sepsis (OR 1.25; CI, 1.034–1.511), and readmission (OR 1.314; CI, 1.224–1.408). However, bleeding disorders were not associated with mortality (OR 0.947; CI, 0.866–1.036) or reoperation (OR 1.061; CI, 0.925–1.220). Conclusions: Hip fracture surgery in patients with bleeding disorders is not associated with higher risks of short-term mortality or reoperation. However, special consideration should be taken when calculating preoperative risks of complications among bleeding disorder patients. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.