Comorbidity and risk of infection among patients with hip fracture : a Danish population-based cohort study
© 2023. The Author(s)..
Impact of comorbidity on infection risk among hip fracture patients is unclear. We found high incidence of infection. Comorbidity was an important risk factor for infection up to 1 year after surgery. Results indicates a need for additional investment in pre- and postoperative programs that assist patients with high comorbidity.
PURPOSE: Comorbidity level and incidence of infection have increased among older patients with hip fracture. The impact of comorbidity on infection risk is unclear. We conducted a cohort study examining the absolute and relative risks of infection in relation to comorbidity level among hip fracture patients.
METHODS: Utilizing Danish population-based medical registries, we identified 92,600 patients aged ≥ 65 years undergoing hip fracture surgery between 2004 and 2018. Comorbidity was categorized by Charlson comorbidity index scores (CCI): none (CCI = 0), moderate (CCI = 1-2), or severe (CCI ≥ 3). Primary outcome was any hospital-treated infection. Secondary outcomes were hospital-treated pneumonia, urinary tract infection, sepsis, reoperation due to surgical-site infection (SSI), and a composite of any hospital- or community-treated infection. We calculated cumulative incidence and hazard ratios (aHRs) adjusted for age, sex, and surgery year, including 95% confidence intervals (CIs).
RESULTS: Prevalence of moderate and severe comorbidity was 40% and 19%, respectively. Incidence of any hospital-treated infection increased with comorbidity level within 0-30 days (none 13% vs. severe 20%) and 0-365 days (none 22% vs. 37% severe). Patients with moderate and severe comorbidity, compared to no comorbidity, had aHRs of 1.3 (CI: 1.3-1.4) and 1.6 (CI: 1.5-1.7) within 0-30 days, and 1.4 (CI: 1.4-1.5) and 1.9 (CI: 1.9-2.0) within 0-365, respectively. Highest incidence was observed for any hospital- or community-treated infection (severe 72%) within 0-365 days. Highest aHR was observed for sepsis within 0-365 days (severe vs. none: 2.7 (CI: 2.4-2.9)).
CONCLUSION: Comorbidity is an important risk factor for infection up to 1 year after hip fracture surgery.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA - 34(2023), 10 vom: 17. Okt., Seite 1739-1749 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gadgaard, N R [VerfasserIn] |
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| Links: |
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| Themen: |
Cohort |
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| Anmerkungen: |
Date Completed 21.09.2023 Date Revised 23.09.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00198-023-06823-6 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358319986 |
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| 100 | 1 | |a Gadgaard, N R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comorbidity and risk of infection among patients with hip fracture |b a Danish population-based cohort study |
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| 500 | |a Date Completed 21.09.2023 | ||
| 500 | |a Date Revised 23.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a Impact of comorbidity on infection risk among hip fracture patients is unclear. We found high incidence of infection. Comorbidity was an important risk factor for infection up to 1 year after surgery. Results indicates a need for additional investment in pre- and postoperative programs that assist patients with high comorbidity | ||
| 520 | |a PURPOSE: Comorbidity level and incidence of infection have increased among older patients with hip fracture. The impact of comorbidity on infection risk is unclear. We conducted a cohort study examining the absolute and relative risks of infection in relation to comorbidity level among hip fracture patients | ||
| 520 | |a METHODS: Utilizing Danish population-based medical registries, we identified 92,600 patients aged ≥ 65 years undergoing hip fracture surgery between 2004 and 2018. Comorbidity was categorized by Charlson comorbidity index scores (CCI): none (CCI = 0), moderate (CCI = 1-2), or severe (CCI ≥ 3). Primary outcome was any hospital-treated infection. Secondary outcomes were hospital-treated pneumonia, urinary tract infection, sepsis, reoperation due to surgical-site infection (SSI), and a composite of any hospital- or community-treated infection. We calculated cumulative incidence and hazard ratios (aHRs) adjusted for age, sex, and surgery year, including 95% confidence intervals (CIs) | ||
| 520 | |a RESULTS: Prevalence of moderate and severe comorbidity was 40% and 19%, respectively. Incidence of any hospital-treated infection increased with comorbidity level within 0-30 days (none 13% vs. severe 20%) and 0-365 days (none 22% vs. 37% severe). Patients with moderate and severe comorbidity, compared to no comorbidity, had aHRs of 1.3 (CI: 1.3-1.4) and 1.6 (CI: 1.5-1.7) within 0-30 days, and 1.4 (CI: 1.4-1.5) and 1.9 (CI: 1.9-2.0) within 0-365, respectively. Highest incidence was observed for any hospital- or community-treated infection (severe 72%) within 0-365 days. Highest aHR was observed for sepsis within 0-365 days (severe vs. none: 2.7 (CI: 2.4-2.9)) | ||
| 520 | |a CONCLUSION: Comorbidity is an important risk factor for infection up to 1 year after hip fracture surgery | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cohort | |
| 650 | 4 | |a Comorbidity | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Hip fracture | |
| 650 | 4 | |a Infections | |
| 700 | 1 | |a Varnum, C |e verfasserin |4 aut | |
| 700 | 1 | |a Nelissen, R G H H |e verfasserin |4 aut | |
| 700 | 1 | |a Vandenbroucke-Grauls, C |e verfasserin |4 aut | |
| 700 | 1 | |a Sørensen, H T |e verfasserin |4 aut | |
| 700 | 1 | |a Pedersen, A B |e verfasserin |4 aut | |
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