Clinical Outcomes and Surgical Complications Among Patients with Bleeding Disorders After Acute Hip Fracture Surgery

Aria D. Darbandi, Ghulam H. Saadat*, Bennet A. Butler, Faran Bokhari

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare short-term (#30 days) outcomes of hip fracture between patients with and without bleeding disorders. Design: Retrospective database review. Setting: The study setting included hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program database. Patients: Patients with acute hip fractures were identified from the National Surgical Quality Improvement Program database between 2016 and 2019. Intervention: Open reduction internal fixation or hemiarthroplasty. Main Outcome Measurements: Mortality, readmission, reoperation, length of stay, and complication were main outcome measurements. Results: There were 63,718 patients undergoing hip surgery, and 16.0% had a bleeding disorder. After adjusting for confounders, multivariable regression models showed that cases with bleeding disorders were associated with higher rates of transfusion [odds ratio (OR) 1.404; confidence interval (CI), 1.335-1.479], myocardial infarction (OR 1.367; CI, 1.190-1.572), pneumonia (OR 1.193; CI, 1.078-1.321), renal failure (OR 1.843; CI, 1.363-2.491), surgical site infections (OR 1.429; CI, 1.185-1.175), sepsis (OR 1.25; CI, 1.034-1.511), and readmission (OR 1.314; CI, 1.224-1.408). However, bleeding disorders were not associated with mortality (OR 0.947; CI, 0.866-1.036) or reoperation (OR 1.061; CI, 0.925-1.220). Conclusions: Hip fracture surgery in patients with bleeding disorders is not associated with higher risks of short-term mortality or reoperation. However, special consideration should be taken when calculating preoperative risks of complications among bleeding disorder patients.

Original languageEnglish (US)
Pages (from-to)104-110
Number of pages7
JournalJournal of orthopaedic trauma
Volume36
Issue number2
DOIs
StatePublished - Feb 1 2022

Keywords

  • Bleeding disorders
  • Complications
  • Hip fracture

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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