Survivorship and Complications after Hip Fracture Surgery in Patients with Chronic Kidney Disease

Abstract

The aim of this study was to investigate survival rate, complications and associated risk factors after hip fracture surgery in patients with chronic kidney disease (CKD) by comparing to non-CKD patients. A total of 119 patients (130 hips, 63 hips CKD group, 67 hips non-CKD) who underwent hip fracture surgery were included. We assessed variables including age, gender, CKD, comorbidities, operation delay and operation time as risk factors for survival and complications after hip fracture surgery. The survival rate was 55.8% at 1-year, 45.8% at 3-year, and 31.4% at 5-year in CKD group, whereas 82.1%, 60.7%, and 36.8%, respectively in non-CKD. Age (more than 85) (hazard ratio [HR], 3.238; 95% confidence interval [CI], 1.736-6.042; P<0.001), stages 4, 5 of CKD (HR, 2.004; 95% CI, 1.170-3.433; P=0.001), cerebrovascular disease (HR, 2.213; 95% CI, 1.196-4.095; P=0.001), and malignancy (HR, 3.086; 95% CI, 1.553-6.129; P=0.001) were significant risk factors. Complications occurred in 17 hips of CKD group and 8 hips of non-CKD. Stage 4-5 of CKD (odds ratio [OR], 3.401; 95% CI, 1.354-8.540; P=0.001), malignancy (OR, 3.184; 95% CI, 0.984-10.301; P=0.050) were significant risk factor. When performing hip fracture surgery in patients with CKD, surgeons should consider age, severity of CKD, and presence of other comorbid disease, such as cerebrovascular disease and malignancy, as patients with these risk factors will need more intensive preoperative and postoperative care.