Abstract：
OBJECTIVE: Comorbidity level is a predictor of infection in the first 30 days after hip fracture surgery. However, the roles of individual comorbid diseases as predictors of infection remain unclear. We investigated individual major comorbid diseases as predictors of infection after hip fracture surgery.
METHODS: We obtained Danish population-based medical registry data for patients undergoing hip fracture surgery (2004-2018). Information was obtained on 27 comorbidities, included in various comorbidity indices, 5 years before surgery. The primary outcome was any hospital-treated infection within 30 days after surgery. Cumulative incidence of infection was calculated by considering death as competing risk. We used logistic regression to compute mutually adjusted odds ratios with 95% confidence interval for infection.
RESULTS: Of 92,239 patients with hip fracture, 71% were women, and the median age was 83 years. The most prevalent comorbidities were hypertension (23%), heart arrhythmia (15%), and cerebrovascular disease (14%). The 30-day incidence of infection was 15% and 12% among the total cohort and among patients with no record of comorbidities, respectively. Infection incidence was highest among patients with renal disease (24%), depression/anxiety (23%), and chronic pulmonary disease (23%), and lowest among patients with metastatic solid tumor (15%). Adjusted odds ratios of infection ranged from 0.94 [0.80-1.10] for metastatic solid tumor to 1.77 [1.63-1.92] for renal disease.
CONCLUSIONS: Most comorbid diseases were predictors of infection after surgery for hip fracture. Awareness of patients\' comorbidity profiles might help clinicians initiate preventive measures or inform patients of their expected risk.
METHODS: We obtained Danish population-based medical registry data for patients undergoing hip fracture surgery (2004-2018). Information was obtained on 27 comorbidities, included in various comorbidity indices, 5 years before surgery. The primary outcome was any hospital-treated infection within 30 days after surgery. Cumulative incidence of infection was calculated by considering death as competing risk. We used logistic regression to compute mutually adjusted odds ratios with 95% confidence interval for infection.
RESULTS: Of 92,239 patients with hip fracture, 71% were women, and the median age was 83 years. The most prevalent comorbidities were hypertension (23%), heart arrhythmia (15%), and cerebrovascular disease (14%). The 30-day incidence of infection was 15% and 12% among the total cohort and among patients with no record of comorbidities, respectively. Infection incidence was highest among patients with renal disease (24%), depression/anxiety (23%), and chronic pulmonary disease (23%), and lowest among patients with metastatic solid tumor (15%). Adjusted odds ratios of infection ranged from 0.94 [0.80-1.10] for metastatic solid tumor to 1.77 [1.63-1.92] for renal disease.
CONCLUSIONS: Most comorbid diseases were predictors of infection after surgery for hip fracture. Awareness of patients\' comorbidity profiles might help clinicians initiate preventive measures or inform patients of their expected risk.
摘要：
目的：合并症水平是髋部骨折术后前30天感染的预测指标。然而,个别共患疾病作为感染预测因子的作用尚不清楚.我们调查了个别主要共患疾病作为髋部骨折手术后感染的预测因子。
方法：我们获得了接受髋部骨折手术患者（2004-2018年）的丹麦人群医学登记数据。获得了27种合并症的信息，包括在各种合并症指数中，手术前5年。主要结果是手术后30天内任何医院治疗的感染。通过将死亡视为竞争风险来计算感染的累积发生率。我们使用逻辑回归计算感染的95%置信区间的相互调整比值比。
结果：在92,239例髋部骨折患者中，71%是女性,中位年龄为83岁。最普遍的合并症是高血压（23％），心律失常（15%），和脑血管疾病(14%)。30天的感染发生率为15％和12％，在总队列和没有合并症记录的患者中，分别。肾病患者感染发生率最高(24%)，抑郁/焦虑（23%），和慢性肺病（23%），在转移性实体瘤患者中最低（15％）。调整后的感染比值比范围从转移性实体瘤的0.94[0.80-1.10]到肾脏疾病的1.77[1.63-1.92]。
结论：大多数合并症是髋部骨折术后感染的预测因子。了解患者的合并症状况可能有助于临床医生采取预防措施或告知患者其预期风险。
方法：我们获得了接受髋部骨折手术患者（2004-2018年）的丹麦人群医学登记数据。获得了27种合并症的信息，包括在各种合并症指数中，手术前5年。主要结果是手术后30天内任何医院治疗的感染。通过将死亡视为竞争风险来计算感染的累积发生率。我们使用逻辑回归计算感染的95%置信区间的相互调整比值比。
结果：在92,239例髋部骨折患者中，71%是女性,中位年龄为83岁。最普遍的合并症是高血压（23％），心律失常（15%），和脑血管疾病(14%)。30天的感染发生率为15％和12％，在总队列和没有合并症记录的患者中，分别。肾病患者感染发生率最高(24%)，抑郁/焦虑（23%），和慢性肺病（23%），在转移性实体瘤患者中最低（15％）。调整后的感染比值比范围从转移性实体瘤的0.94[0.80-1.10]到肾脏疾病的1.77[1.63-1.92]。
结论：大多数合并症是髋部骨折术后感染的预测因子。了解患者的合并症状况可能有助于临床医生采取预防措施或告知患者其预期风险。
