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Determinants of mortality after hip fracture surgery in Sweden: a registry-based retrospective cohort study
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
Sahlgrens Univ Hosp, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
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2018 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, article id 15695Article in journal (Refereed) 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.

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NATURE PUBLISHING GROUP , 2018. Vol. 8, article id 15695
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Cardiac and Cardiovascular Systems
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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
Note

Funding Agencies|Region Ostergotland County Council

Available from: 2018-11-09 Created: 2018-11-09 Last updated: 2019-09-19

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Åhman, RasmusForsberg Siverhall, PontusFredrikson, MatsBjörnström, KarinChew, Michelle
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Division of Drug ResearchFaculty of Medicine and Health SciencesDepartment of Anaesthesiology and Intensive Care in LinköpingDivision of Neuro and Inflammation Science
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