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17-06-2024 | Chronic Kidney Disease | Original Research

Effect of Chronic Kidney Disease on All-Cause Mortality After Hip Fracture Surgery: A Retrospective Cohort Study

Authors: Yun Seo Jang, Hyunkyu Kim, Soo Young Kim, Yu Shin Park, Il Yun, Eun-Cheol Park, Suk-Yong Jang

Published in: Calcified Tissue International | Issue 2/2024

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Abstract

In this retrospective cohort study, we investigated: (1) The impact of comorbid chronic kidney disease (CKD) on postoperative mortality in patients with a hip fracture; (2) mortality variations by dialysis type, potentially indicating CKD stage; (3) the efficacy of different hip fracture surgical methods in reducing mortality for patients with CKD. This study included 25,760 patients from the Korean National Health Insurance Service-Senior cohort (2002–2019) who underwent hip fracture surgery. Participants were categorized as CKD and Non-CKD. Mortality rate was determined using a generalized linear model with a Poisson distribution. The effect size was presented as a hazard ratio (HR) through a Cox proportional-hazard model. During follow-up, we ascertained that 978 patients (3.8%) had CKD preoperatively. Compared to the Non-CKD group, the mortality risk (HR) in the CKD group was 2.17 times higher (95% confidence interval [CI], 1.99–2.37). In sensitivity analysis, the mortality risk of in patients who received peritoneal dialysis and hemodialysis was 6.21 (95% CI, 3.90–9.87) and 3.62 times (95% CI, 3.11–4.20) higher than that of patients who received conservative care. Mortality risk varied by surgical method: hip hemiarthroplasty (HR, 2.11; 95% CI, 1.86–2.40), open reduction and internal fixation (HR, 2.21; 95% CI, 1.94–2.51), total hip replacement (HR, 2.27; 95% CI, 1.60–3.24), and closed reduction and percutaneous fixation (HR, 3.08; 95% CI, 1.88–5.06). Older patients with CKD undergoing hip fracture surgery had elevated mortality risk, necessitating comprehensive pre- and postoperative assessments and management.
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Metadata
Title
Effect of Chronic Kidney Disease on All-Cause Mortality After Hip Fracture Surgery: A Retrospective Cohort Study
Authors
Yun Seo Jang
Hyunkyu Kim
Soo Young Kim
Yu Shin Park
Il Yun
Eun-Cheol Park
Suk-Yong Jang
Publication date
17-06-2024
Publisher
Springer US
Published in
Calcified Tissue International / Issue 2/2024
Print ISSN: 0171-967X
Electronic ISSN: 1432-0827
DOI
https://doi.org/10.1007/s00223-024-01238-9

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