Incidence and risk factors associated with postoperative stroke in the elderly patients undergoing hip fracture surgery

Journal of Orthopaedic Surgery and Research

Lili Yu¹  Hui Bu¹  Yanbin Zhu²  Wei Chen²  Yingze Zhang³ 

[1] Department of Neurology, The 2nd Hospital of Hebei Medical University, 050000, Shijiazhuang, Hebei, People’s Republic of China;Key Laboratory of Neurology of Hebei Province, 050000, Shijiazhuang, Hebei, People’s Republic of China;Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, 050051, Shijiazhuang, Hebei, People’s Republic of China;Key Laboratory of Biomechanics of Hebei Province, 050051, Shijiazhuang, Hebei, People’s Republic of China;Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, 050051, Shijiazhuang, Hebei, People’s Republic of China;Key Laboratory of Biomechanics of Hebei Province, 050051, Shijiazhuang, Hebei, People’s Republic of China;Chinese Academy of Engineering, 100088, Beijing, People’s Republic of China;

关键词: Epidemiology;    Hip fracture;    Multivariate analyses;    Risk factors;    Stroke;   

DOI  :  10.1186/s13018-020-01962-6

来源: Springer

【 摘 要 】

ObjectivesStroke is one of the rare but devastating complications after hip fracture in the elderly. By far, there is still scarce data on postoperative stroke in elderly patients with hip fractures.MethodsThis was a retrospective study of prospectively collected data. Between October 2014 to December 2018, patients aged above 65 years who underwent operative treatment for hip fractures were included. Inpatient medical surveillance and scheduled telephone follow-up at 1, 3, 6, and 12 months after operation was conducted to identify who developed an incident stroke. Variables of interests were extracted from patients’ inpatient medical records. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors associated with stroke.ResultsDuring the study period, a total of 3743 patients were included, among whom 56 were found to have a stroke after operation, representing an incidence of 1.5% (95% CI, 1.1 to 1.9%). The multivariate analyses showed that advanced age (1-year increment; OR, 1.32; 95% CI, 1.08 to 1.48), history of previous stroke (OR, 4.79; 95% CI, 1.86 to 6.56), ASA III and above (OR, 2.62; 95% CI, 1.27 to 3.68), long-term use of aspirin (OR, 3.63; 95% CI, 1.41 to 4.78), and elevated RDW level (each increment of 1%, OR, 1.21; 95% CI, 1.02 to 1.36) were independently associated with postoperative stroke.ConclusionsAlthough most are not modifiable, these risk factors help in counseling patients regarding the risk of postoperative stroke, individual risk stratification, and targeted optimization of medical conditions and should be firmly kept in treating surgeon’s mind.

【 授权许可】

CC BY