Author(s): Naraen S.; Burke D.; Shamim S.; Isaac L.; Attwood J.; Lee S.; Khare A.; Brezezinska M.; Sameul M.; Davis H.; Austin G.; Maddison A.; Torrance R.; Baird S.; Temperton A.; Ward O.; Middleton S.; Pemble I.; Pandya B.
Source: Osteoporosis International; 2018; vol. 29 (no. 1)
Publication Date: 2018
Publication Type(s): Conference Abstract
Available at Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA – from SpringerLink – Medicine
Abstract:Objective: Femoral neck fracture in elderly can be debilitating or even fatal. Acute kidney Injury represents frequent complication after hip fracture surgery. The reported incidence of acute kidney injury in elderly patients undergoing hip fracture surgery ranges from 15.3- 24.4% according to the definition of acute kidney injury. 7-11% of patients undergoing orthopaedics surgery will experience acute kidney injury. AKI following hip fracture has multi-factorial causes. Baseline renal function, age, comorbidities, dehydration, nephrotoxic drugs, and malnutrition are documented risk factors for AKI. Our aim was to identify the preventable risk factor in perioperative period so that we can decrease the incidence of acute kidney Injury in patient going for emergency hip surgery Methods: A retrospective data was collected for all the patients with hip fracture who underwent emergency surgery above 60 years of age between January 2016 and January 2017. Total of 328 patients were included in the analysis. Result: 99 Male and 229 females were admitted with Fracture Neck of femur. Most of them had the surgery within 48 h. Hypertension was the most common comorbidity in both Non AKI 39% (n=108) and AKI group44% (n=24). Whereas in Non AKI, CKD was 9.5% (n=26) and 12.7% (n=35) were diabetic. 23.3% (n=64) patients were on ACE inhibitors, 8.3% on angiotensin II receptor blockers (ARB), 7.2% were on 7.2% furosemide. In AKI group hypertension was found in 44% (n=24) patients, CKD in 12% (n=9) patients and 16% (n=9) were diabetic. 18.5% (n=10) on ACE inhibitor, 9.2% on ARB and 14.4%(n=8) were on furosemide. The mean creatinine in Non AKI group is 96 and in Non AKI group is 156. 10% of patients AKI did not resolved and 70% (n=7) of the patients died. 50% of those patients had hypertension and heart disease. Conclusion: Most of the patients with unresolved AKI died. Double the percentages of patients were on furosemide in AKI group. Pre-operative CKD as comorbidity was not statistically significant risk factor (p=0.4580) however the pre-operative creatinine value was an important factor responsible for the development of AKI (p<=0.0001).