Incidence and risk factors associated with postoperative stroke in the elderly patients undergoing hip fracture surgery
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(2020) 15:429
RESEARCH ARTICLE
Open Access
Incidence and risk factors associated with postoperative stroke in the elderly patients undergoing hip fracture surgery Lili Yu1,2†, Yanbin Zhu3,4†, Wei Chen3,4, Hui Bu1,2* and Yingze Zhang3,4,5*
Abstract Objectives: Stroke is one of the rare but devastating complications after hip fracture in the elderly. By far, there is still scarce data on postoperative stroke in elderly patients with hip fractures. Methods: This was a retrospective study of prospectively collected data. Between October 2014 to December 2018, patients aged above 65 years who underwent operative treatment for hip fractures were included. Inpatient medical surveillance and scheduled telephone follow-up at 1, 3, 6, and 12 months after operation was conducted to identify who developed an incident stroke. Variables of interests were extracted from patients’ inpatient medical records. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors associated with stroke. Results: During the study period, a total of 3743 patients were included, among whom 56 were found to have a stroke after operation, representing an incidence of 1.5% (95% CI, 1.1 to 1.9%). The multivariate analyses showed that advanced age (1-year increment; OR, 1.32; 95% CI, 1.08 to 1.48), history of previous stroke (OR, 4.79; 95% CI, 1.86 to 6.56), ASA III and above (OR, 2.62; 95% CI, 1.27 to 3.68), long-term use of aspirin (OR, 3.63; 95% CI, 1.41 to 4.78), and elevated RDW level (each increment of 1%, OR, 1.21; 95% CI, 1.02 to 1.36) were independently associated with postoperative stroke. Conclusions: Although most are not modifiable, these risk factors help in counseling patients regarding the risk of postoperative stroke, individual risk stratification, and targeted optimization of medical conditions and should be firmly kept in treating surgeon’s mind. Keywords: Epidemiology, Hip fracture, Multivariate analyses, Risk factors, Stroke
* Correspondence: [email protected]; [email protected] † Lili Yu and Yanbin Zhu contributed equally to this work. 1 Department of Neurology, The 2nd Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, People’s Republic of China 3 Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, People’s Republic of China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative
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