Analysis of Perioperative Complications of Surgery for Proximal Femur Fracture in Elderly Patients Older than 75 Years

Tsuyoshi Nakai, Kunihiko Hashimoto, Atsunori Onishi, Toshiyuki Nakamura, Akira Miyama, Naohiro Yasuda

Department of Orthopaedic Surgery, Itami City Hospital, Itami, Japan.

DOI: 10.4236/ojo.2013.32017                

Abstract

Background: In elderly patients with femoral neck fracture, functional recovery is affected largely by preoperative underlying diseases and postoperative complications. The present study was designed to analyze the relationship between preoperative underlying diseases and perioperative complications of surgery for proximal femur fracture. Methods: The study involved 86 patients aged 75 years or older, who underwent surgery for proximal femur fracture. Each patient was examined for the presence of preoperative underlying diseases and preoperative biochemical test data. Moderate and severe complications, which were life-threatening and necessitated treated, were investigated during the perioperative period. A retrospective analysis was conducted on the relationship of preoperative underlying diseases and preoperative biochemical data with the moderate or severe complications that developed during the perioperative period. Results: Eighty-one patients developed a preoperative underlying disease, with hypertension being most frequent (42 cases). Complications during the perioperative period were observed in 58 patients, with anemia develops most frequently (23 cases). Moderate or severe complications during the perioperative period were observed in 16 patients, and infection was the most frequent complication (8 cases). In the statistical analysis, a significant difference in the incidence of moderate or severe perioperative complications was observed only in the users of anticoagulants/antiplatelet drugs. Discussion: Patients of preoperative use of anticoagulants/antiplatelet drugs should be closely managed medically so that perioperative medical complications can be managed.

Keywords

Perioperative Complications; Proximal Femur Fracture; Elderly Patients

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	National Livelihood Survey, “The Ministry of Health, Labour and Welfare,” Japan, 2007.
[2]	A. Kudo, A. Masuoka and A. Matsuki, “Analysis of PeRioperative Complications in Patients with Femoral Neck Fracture Aged over 80,” Orthopedic Surgery, Vol. 44, 1993, pp. 1858-1861.
[3]	K. Sakamoto, T. Nakamura, H. Hagino, N. Endo, S. Mori, Y. Muto, A. Harada, S. Yamamoto, K. Kushida, M. Yoshimura and H. Yamamoto, “Report on the Japanese Orthopaedic Association’s 3-Year Project Observing Hip Fracture at Fixed-Point Hospitals,” Journal of Orthopaedic Science, Vol. 11, No. 2, 2006, pp. 127-134. doi:10.1007/s00776-005-0998-1
[4]	Y. Asao, T. Higuchi and Y. Shimoda, “Analysis of PeRioperative Complications among 449 Elderly Patients with Femoral Neck Facture Treated Surgically,” Journal of Clinical Anestheology, Vol. 25, 2005, p. 323.
[5]	S. Kawahara, K. Sato, T. Ando, S. Kitamura and K. Miyasaka, “Perioperative Complications and Their Management in Patients with Femoral Neck Fracture in Late Senility,” Central Japan Journal of Orthopaedic Traumtology, Vol. 45, 2002, pp. 871-872.
[6]	K. Ichimura and T. Ishii, “Prognosis of Elderly Patients with Proximal Femur Fracture Accompanied by Medical Disease,” Central Japan Journal of Orthopaedic Traumatology, Vol. 45, 2002, pp. 861-862.
[7]	K. Otani and Y. Inomata, “Perioperative Complications and Prognosis as to Survival in Elderly Patients with Femoral Neck Facture,” Journal of the Eastern Japan Association of Orthopaedics and Traumatology, Vol. 15, 2003, pp. 569-574.