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Determinants of mortality after hip fracture surgery in Sweden: a registry-based retrospective cohort study
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten.
Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken US.
Sahlgrens Univ Hosp, Sweden.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
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2018 (Engelska)Ingår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, artikel-id 15695Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Surgery for hip fractures is associated with high mortality and morbidity. The causes of poor outcome are not fully understood and may be related to other factors than the surgery itself. The relative contributions of patient, surgical, anaesthetic and structural factors have seldom been studied together. This study, a retrospective registry-based cohort study of 14 932 patients undergoing hip fracture surgery in Sweden from 1st of January 2014 to 31st of December 2016, aimed to identify important predictors of mortality post-surgery. The independent predictive power of our included variables was examined using Cox proportional hazards modeling with all-cause mortality at longest follow-up as the outcome. Twelve independent variables were considered as interrelated exposures and their individual adjusted effect within a single model were evaluated. Kaplan-Meier curves were also generated. Crude mortality rates were 8.2% at 30 days (95% CI 7.7-8.6%) and 23.6% at 365 days (95% CI 22.9-24.2%). Of the 12 factors entered into the Cox regression analysis, age (aHR1.06, p amp;lt; 0.001), male gender (aHR 1.45, p amp;lt; 0.001), ASA-PS-class (ASA 1amp;2 reference; ASA 3 aHR 2.12; ASA 4 aHR 4.79; ASA 5 aHR 12.57 respectively, p amp;lt; 0.001) and PACU-LOS (aHR 1.01, p amp;lt; 0.001) were significantly associated with mortality at longest follow-up (up to 3 years). University hospital status was protective (aHR 0.83, p amp;lt; 0.001) in the same model. Age, gender and ASA-PS-class were strong predictors of mortality after surgery for hip fractures in Sweden. University hospital status and length of stay in the postoperative care unit were also identified as modifiable risk factors after multivariable adjustment and require confirmation in future studies.

Ort, förlag, år, upplaga, sidor
NATURE PUBLISHING GROUP , 2018. Vol. 8, artikel-id 15695
Nationell ämneskategori
Kardiologi
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URN: urn:nbn:se:liu:diva-152612DOI: 10.1038/s41598-018-33940-8ISI: 000448109000020PubMedID: 30356058OAI: oai:DiVA.org:liu-152612DiVA, id: diva2:1262109
Anmärkning

Funding Agencies|Region Ostergotland County Council

Tillgänglig från: 2018-11-09 Skapad: 2018-11-09 Senast uppdaterad: 2019-09-19

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Åhman, RasmusForsberg Siverhall, PontusFredrikson, MatsBjörnström, KarinChew, Michelle
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Avdelningen för läkemedelsforskningMedicinska fakultetenAnestesi- och intensivvårdskliniken USAvdelningen för neuro- och inflammationsvetenskap
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