Clinical features and risk factors of acute kidney injury after hip fracture in the elderly

doi:10.3969/j.issn.1004-583X.2021.05.011

Abstract

Abstract:

Objective To investigate clinical characteristics and risk factors of acute kidney injury(AKI) after hip fracture in the elderly. Methods Four hundred and seventy patients undergoing hip fracture surgeries were selected. According to the criteria for acute kidney injury, the patients were divided into non-AKI group (276 cases) and AKI group (194 cases). The white blood cells (WBC), red blood cells (RBC), serum creatinine (SCr), blood urea nitrogen (BUN), albumin (ALB), glomerular filtration rate (eGFR), hemoglobin (Hb) indicators, acid-base balance (pH), partial pressure of arterial oxygen (PaO₂), partial pressure of arterial carbon dioxide (PaCO₂), bicarbonate radical (HCO3), serum potassium (K⁺), serum calcium (Ca²⁺) indicators were detected between the two groups, and related prognostic risk factors were analyzed. Results Coronary heart disease, diabetes, hypotension, the index of WBC, ALB. GFR in the two groups were statistically significant difference (P<0.05). Compared the non-AIK group, the operation duration, intraoperative blood loss, and anesthesia duration in AKI group were significantly higher (P<0.05). SCr, BUN and length of length of hospitalization in AKI group were significantly higher (P<0.05). 24-hour urine output in AKI group were significantly lower (P<0.05). pH, HCOs and K⁺ in AKI group were significantly higher (P<0.05). PaO₂, PaCO₂, and Ca²⁺ of AKI group were significantly lower (P<0.05). The coronary heart disease, diabetes, hypotension, WBC, ALLB and eGFR, length of Length of hospitalization were independent risk factors for AKI in hip surgery in elderly patients (P<0.05). Conclusion If the elderly patients have underlying diseases involving coronary heart disease, diabetes, and hypotension before hip fracture surgeries, they would have a higher risk of post-operative AKI. The treatment for such elderly patients become more difficult and increase the risk of death which will have an impact on the prognosis recovery.

Key words: acute kidney injury, post-operative hip fracture surgery, prognostic

CLC Number:

R692.5

Zhang Linli, Ma Xiaohong. Clinical features and risk factors of acute kidney injury after hip fracture in the elderly[J]. Clinical Focus, 2021, 36(5): 442-445.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.05.011

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I5/442

Figures/Tables 5

References 14

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组别		例数		性别(例)			年龄(岁)			体重指数 (kg/m²)		吸烟史 [例(%)]		冠心病史 [例(%)]		高血压史 [例(%)]
组别		例数		男		女	年龄(岁)			体重指数 (kg/m²)		吸烟史 [例(%)]		冠心病史 [例(%)]		高血压史 [例(%)]
AKI组		194		102		92	65.27±6.31			24.61±1.31		18(9.3)		14(7.2)		16(8.3)
非AKI组		276		140		136	65.33±5.29			24.42±1.22		32(11.6)		31(11.2)		17(6.2)
t/χ²值				0.157			0.112			1.612		0.643		6.422		0.761
P值				0.692			0.911			0.108		0.423		0.011		0.383
组别	例数		糖尿病史 [例(%)]		低血压史 [例(%)]			WBC (×10⁹/L)	RBC (×10⁹/L)		ALB (g/L)		Hb (g/L)		eGFR [ml/(min·1.73 m²)]
AKI组	194		43(22.2)		47(24.2)			13.82±0.78	3.66±0.77		42.22±2.18		110.53±14.48		53.11±16.32
非AKI组	276		20(7.3)		11(4.0)			6.43±0.65	3.65±0.83		33.29±1.97		110.32±12.31		71.31±11.51
t/χ²值			21.840		43.150			111.600	0.133		46.290		0.169		14.180
P值			<0.01		<0.01			<0.01	0.895		<0.01		0.866		<0.01

组别		例数		性别(例)			年龄(岁)			体重指数 (kg/m²)		吸烟史 [例(%)]		冠心病史 [例(%)]		高血压史 [例(%)]
组别		例数		男		女	年龄(岁)			体重指数 (kg/m²)		吸烟史 [例(%)]		冠心病史 [例(%)]		高血压史 [例(%)]
AKI组		194		102		92	65.27±6.31			24.61±1.31		18(9.3)		14(7.2)		16(8.3)
非AKI组		276		140		136	65.33±5.29			24.42±1.22		32(11.6)		31(11.2)		17(6.2)
t/χ²值				0.157			0.112			1.612		0.643		6.422		0.761
P值				0.692			0.911			0.108		0.423		0.011		0.383
组别	例数		糖尿病史 [例(%)]		低血压史 [例(%)]			WBC (×10⁹/L)	RBC (×10⁹/L)		ALB (g/L)		Hb (g/L)		eGFR [ml/(min·1.73 m²)]
AKI组	194		43(22.2)		47(24.2)			13.82±0.78	3.66±0.77		42.22±2.18		110.53±14.48		53.11±16.32
非AKI组	276		20(7.3)		11(4.0)			6.43±0.65	3.65±0.83		33.29±1.97		110.32±12.31		71.31±11.51
t/χ²值			21.840		43.150			111.600	0.133		46.290		0.169		14.180
P值			<0.01		<0.01			<0.01	0.895		<0.01		0.866		<0.01

组别	例数	手术时间 (min)	术中出血量 (ml)	麻醉时间 (min)
AKI组	194	131.53±12.42	110.33±11.42	142.45±34.28
非AKI组	276	56.38±11.42	84.41±12.13	122.61±21.43
t值		22.517	27.342	19.487
P值		0.001	0.001	0.001

组别	例数	手术时间 (min)	术中出血量 (ml)	麻醉时间 (min)
AKI组	194	131.53±12.42	110.33±11.42	142.45±34.28
非AKI组	276	56.38±11.42	84.41±12.13	122.61±21.43
t值		22.517	27.342	19.487
P值		0.001	0.001	0.001

组别	例数	SCr(μmol/L)	BUN(mmol/L)	术后24 h尿量(ml)	住院时间(d)
AKI组	194	113.96±32.28	12.78±3.28	441.42±76.48	20.33±2.14
非AKI组	276	81.32±9.21	6.33±1.24	1 210.37±118.16	15.33±2.32
t(t’)值		16.392	6.197	71.912	5.139
P值		0.001	0.021	0.001	0.034