Study identifies high-impact postoperative complications in older patients undergoing hip fracture repair
A new study in The Joint Commission Journal on Quality and Patient Safety assessed which complications are associated with the highest mortality rates and resource utilization for older patients who undergo hip fracture repair, reported the commission.
The study, “The Relative Impact of Specific Postoperative Complications on Older Patients Undergoing Hip Fracture Repair,” details how researchers used data for patients aged 65 years and older from the 2016–2017 Hip Fracture Targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Hip fracture in older patients is common, debilitating and costly.
Population attributable fractions (PAFs) were used to quantify the anticipated reduction in the primary outcomes (30-day mortality and readmission) that would result from complete prevention of 10 postoperative complications. In 17,755 patients who underwent hip fracture repair across 117 hospitals, postoperative delirium and pneumonia were the highest-impact complications.
Postoperative delirium affected 29.8% of patients and was associated with:
· 30-day mortality (11.5%)
· Prolonged hospitalization (43%)
· 30-day hospital readmission (11.9%)
Pneumonia affected 4.1% of patients and was associated with:
· 30-day mortality (27.3%)
· Prolonged hospitalization (66%)
· 30-day hospital readmission (28.1%)
The impact of the other eight complications – bleeding, Clostridium difficile colitis, decubitus ulcer, myocardial infarction, stroke, surgical site infection, urinary tract infection and venous thromboembolism – was comparatively small.
