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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

01.12.2012 | Trauma Surgery

Biochemical lung, liver and kidney markers and early death among elderly following hip fracture

verfasst von: Ove Talsnes, Fredrik Hjelmstedt, Ola E. Dahl, Are Hugo Pripp, Olav Reikerås

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 12/2012

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Abstract

Introduction

In the elderly, hip fracture is a common injury associated with high early mortality dominated by cardiorespiratory and thromboembolic events. Identification of risk factors that can be modified by treatment has caught attention over the last years. This study was conducted to assess biological markers on perioperative organ dysfunction and its association with early mortality within 3 months after surgery.

Method

Blood samples were collected before, during and until 4 days after surgery. Analyses on PaO₂, alanine aminotransaminase (ALAT), gamma-glutamyl transpeptidase (g-GT) and creatinine were performed and used as markers on lung, liver and kidney functions.

Patients

Three hundred and two patients over 75 years of age with acute dislocated hip fracture were consecutively enrolled from two hospitals in Norway.

Results

We found a positive correlation between the plasma levels of ALAT, creatinine and death, and an inverse relationship between PaO₂ and death. After controlling for confounding factors such as sex, age and comorbidity, ALAT and creatinine levels were shown to be significantly and independently related to risk for fatal outcome.

Conclusion

Our results provide data on clinically important biomarkers in patients undergoing hip fracture surgery. We suggest a stronger emphasis on monitoring and correcting these biomarkers when possible.

Carretta E, Bochicchio V, Rucci P, Fabbri G, Laus M, Fantini MP (2010) Hip fracture: effectiveness of early surgery to prevent 30-day mortality. Int Orthop 35:419–424PubMedCrossRef

Haentjens P, Magaziner J, Colon-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390PubMed

Johnston AT, Barnsdale L, Smith R, Duncan K, Hutchison JD (2010) Change in long-term mortality associated with fractures of the hip: evidence from the scottish hip fracture audit. J Bone Joint Surg Br 92(7):989–993PubMedCrossRef

Talsnes O, Hjelmstedt F, Dahl OE, Pripp AH, Reikeras O (2011) Clinical and biochemical prediction of early fatal outcome following hip fracture in the elderly. Int Orthop 35:903–907PubMedCrossRef

Bhaskar D, Parker MJ (2010) Haematological indices as surrogate markers of factors affecting mortality after hip fracture. Injury 42:178–182CrossRef

Bjorgul K, Novicoff WM, Saleh KJ (2010) American society of anesthesiologist physical status score may be used as a comorbidity index in hip fracture surgery. J Arthroplast 25(6 Suppl):134–137CrossRef

Eiskjaer S, Ostgard SE (1991) Risk factors influencing mortality after bipolar hemiarthroplasty in the treatment of fracture of the femoral neck. Clin Orthop Relat Res 270:295–300PubMed

Harris IA, Yong S, McEvoy L, Thorn L (2010) A prospective study of the effect of nursing home residency on mortality following hip fracture. ANZ J Surg 80(6):447–450PubMedCrossRef

Holvik K, Ranhoff AH, Martinsen MI, Solheim LF (2010) Predictors of mortality in older hip fracture inpatients admitted to an orthogeriatric unit in oslo, norway. J Aging Health 22(8):1114–1131PubMedCrossRef

10.

O’Malley NT, Blauth M, Suhm N, Kates SL (2011) Hip fracture management, before and beyond surgery and medication: a synthesis of the evidence. Arch Orthop Trauma Surg 131(11):1519–1527PubMedCrossRef

11.

Liao L, Zhao JM, Su W, Ding XF, Chen LJ, Luo SX (2012) A meta-analysis of total hip arthroplasty and hemiarthroplasty outcomes for displaced femoral neck fractures. Arch Orthop Trauma Surg. doi:10/1007/s00402-012-1485-8 PubMed

12.

Adunsky A, Mizrahi EH, Kaplan A, Purits E, Waitzman A, Arad M (2010) Elevated blood urea, independent of glomerular filtration rate (GFR), confers increased risk of adverse functional outcome in elderly hip fracture patients. Arch Gerontol Geriatr 53:174–178CrossRef

13.

Gregersen M, Zintchouk D, Hougaard K, Krogshede A, Almasi F, Holm-Petersen IO, Damsgaard EM (2010) Interdisciplinary geriatric intervention among nursing home residents with hip fracture reduces mortality. Ugeskr Laeger 172(25):1902–1907PubMed

14.

Nitsch D, Mylne A, Roderick PJ, Smeeth L, Hubbard R, Fletcher A (2009) Chronic kidney disease and hip fracture-related mortality in older people in the UK. Nephrol Dial Transplant 24(5):1539–1544PubMedCrossRef

15.

Rahme E, Kahn SR, Dasgupta K, Burman M, Bernatsky S, Habel Y, Berry G (2010) Short-term mortality associated with failure to receive home care after hemiarthroplasty. CMAJ 182(13):1421–1426PubMedCrossRef

16.

Shyu YI, Liang J, Wu CC, Su JY, Cheng HS, Chou SW, Chen MC, Yang CT, Tseng MY (2010) Two-year effects of interdisciplinary intervention for hip fracture in older Taiwanese. J Am Geriatr Soc 58(6):1081–1089PubMedCrossRef

17.

Moroni A, Hoque M, Waddell JP, Russell TA, Wippermann B, Digiovanni G (2011) Surgical treatment and management of hip fracture patients. Arch Orthop Trauma Surg. doi:10.1007/s00402-011-1441-z

18.

Kammerlander C, Gosch M, Kammerlander-Knauer U, Luger TJ, Blauth M, Roth T (2011) Long-term functional outcome in geriatric hip fracture patients. Arch Orthop Trauma Surg 131(10):1435–1444PubMedCrossRef

19.

Hu F, Jiang C, Shen J, Tang P, Wang Y (2011) Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury. doi:10/1016/j.injury.2011.05.017

20.

Owens WD, Felts JA, Spitznagel EL Jr (1978) ASA physical status classification: a study of consistency of ratings. Anesthesiology 49(4):239–243PubMedCrossRef

21.

Giercksky KE, Bjorklid E, Prydz H, Renck H (1979) Circulating tissue thromboplastin during hip surgery. Eur Surg Res 11(4):296–300PubMedCrossRef

22.

Dahl OE, Pedersen T, Kierulf P, Westvik AB, Lund P, Arnesen H, Seljeflot I, Abdelnoor M, Lyberg T (1993) Sequential intrapulmonary and systemic activation of coagulation and fibrinolysis during and after total hip replacement surgery. Thromb Res 70(6):451–458PubMedCrossRef

23.

Bjorkelund KB, Hommel A, Thorngren KG, Lundberg D, Larsson S (2009) Factors at admission associated with 4 months outcome in elderly patients with hip fracture. AANA J 77(1):49–58PubMed

24.

Singh MK, Mehra A, Yunas I, Nightingale P, Porter K (2008) Is estimated peri-operative glomerular filtration rate associated with post-operative mortality in fractured neck of femur patients? Injury 39(10):1141–1146CrossRef

25.

Fox KM, Hawkes WG, Magaziner J, Zimmerman SI, Hebel JR (1996) Markers of failure to thrive among older hip fracture patients. J Am Geriatr Soc 44(4):371–376PubMed

26.

Goh R, Mori K, Abe T, Kohyama A, Minato A (1996) Delayed hypoxia after the surgical correction of femoral neck fracture. Masui 45(11):1323–1329PubMed

27.

Juliebo V, Krogseth M, Skovlund E, Engedal K, Wyller TB (2010) Medical treatment predicts mortality after hip fracture. J Gerontol A Biol Sci Med Sci 65(4):442–449PubMedCrossRef

28.

Abrahamsen B, Van ST, Ariely R, Olson M, Cooper C (2009) Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 20(10):1633–1650PubMedCrossRef

29.

Kotyra M, Houltz E, Ricksten SE (2010) Pulmonary haemodynamics and right ventricular function during cemented hemiarthroplasty for femoral neck fracture. Acta Anaesthesiol Scand 54(10):1210–1216PubMedCrossRef

30.

Lo IL, Siu CW, Tse HF, Lau TW, Leung F, Wong M (2010) Pre-operative pulmonary assessment for patients with hip fracture. Osteoporos Int 21(Suppl 4):S579–S586PubMedCrossRef

31.

Pitto RP, Hamer H, Fabiani R, Radespiel-Troeger M, Koessler M (2002) Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis: a controlled, randomized clinical trial. J Bone Joint Surg Am 84-A(1):39–48PubMed

32.

Parvizi J, Holiday AD, Ereth MH, Lewallen DG (1999) The frank stinchfield award. Sudden death during primary hip arthroplasty. Clin Orthop Relat Res 369:39–48PubMedCrossRef

33.

Giercksky KE, Bjorklid E, Prydz H (1976) The effect of intravenous injection of purified human tissue thromboplastin in rats. Scand J Haematol 16(4):300–310PubMedCrossRef

34.

Dahl OE (1997) The role of the pulmonary circulation in the regulation of coagulation and fibrinolysis in relation to major surgery. J Cardiothorac Vasc Anesth 11(3):322–328PubMedCrossRef

35.

Dahl OE (1997) Cardiorespiratory and vascular dysfunction related to major reconstructive orthopedic surgery. Acta Orthop Scand 68(6):607–614PubMedCrossRef

36.

Kakkar AK, Brenner B, Dahl OE, Eriksson BI, Mouret P, Muntz J, Soglian AG, Pap AF, Misselwitz F, Haas S (2008) Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial. Lancet 372(9632):31–39PubMedCrossRef

37.

Zimmerman HJ (2010) Drug-induced liver disease. Clin Liver Dis 4(1):73–96CrossRef

Titel: Biochemical lung, liver and kidney markers and early death among elderly following hip fracture
verfasst von: Ove Talsnes
Fredrik Hjelmstedt
Ola E. Dahl
Are Hugo Pripp
Olav Reikerås
Publikationsdatum: 01.12.2012
Verlag: Springer-Verlag
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 12/2012
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-012-1611-7

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Introduction

Method

Patients

Results

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