Major comorbid diseases as predictors of infection in the first month after hip fracture surgery: a population-based cohort study in 92,239 patients

Nadia Roldsgaard Gadgaard; Claus Varnum; Rob Nelissen; Christina Vandenbroucke-Grauls; Henrik Toft Sørensen; Alma Becic Pedersen

doi:10.1007/s41999-024-00989-w

Major comorbid diseases as predictors of infection in the first month after hip fracture surgery: a population-based cohort study in 92,239 patients

Nadia Roldsgaard Gadgaard, Claus Varnum, Rob Nelissen, Christina Vandenbroucke-Grauls, Henrik Toft Sørensen, Alma Becic Pedersen

Department of Clinical Medicine - Department of Clinical Epidemiology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

2 Citations (Scopus)

Abstract

PURPOSE: 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.

CONCLUSION: 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.

Original language	English
Journal	European Geriatric Medicine
Volume	15
Issue	4
Pages (from-to)	1069-1080
Number of pages	12
ISSN	1878-7649
DOIs	https://doi.org/10.1007/s41999-024-00989-w
Publication status	Published - Aug 2024

Keywords

Comorbidity
Epidemiology
Geriatrics
Hip fracture
Infections
Population based

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10.1007/s41999-024-00989-wLicence: CC BY

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title = "Major comorbid diseases as predictors of infection in the first month after hip fracture surgery: a population-based cohort study in 92,239 patients",

abstract = "PURPOSE: 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.CONCLUSION: 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.",

keywords = "Comorbidity, Epidemiology, Geriatrics, Hip fracture, Infections, Population based",

author = "Gadgaard, {Nadia Roldsgaard} and Claus Varnum and Rob Nelissen and Christina Vandenbroucke-Grauls and S{\o}rensen, {Henrik Toft} and Pedersen, {Alma Becic}",

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doi = "10.1007/s41999-024-00989-w",

language = "English",

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Major comorbid diseases as predictors of infection in the first month after hip fracture surgery: a population-based cohort study in 92,239 patients. / Gadgaard, Nadia Roldsgaard; Varnum, Claus; Nelissen, Rob et al.
In: European Geriatric Medicine, Vol. 15, No. 4, 08.2024, p. 1069-1080.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Major comorbid diseases as predictors of infection in the first month after hip fracture surgery

T2 - a population-based cohort study in 92,239 patients

AU - Gadgaard, Nadia Roldsgaard

AU - Varnum, Claus

AU - Nelissen, Rob

AU - Vandenbroucke-Grauls, Christina

AU - Sørensen, Henrik Toft

AU - Pedersen, Alma Becic

PY - 2024/8

Y1 - 2024/8

N2 - PURPOSE: 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.CONCLUSION: 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.

AB - PURPOSE: 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.CONCLUSION: 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.

KW - Comorbidity

KW - Epidemiology

KW - Geriatrics

KW - Hip fracture

KW - Infections

KW - Population based

UR - http://www.scopus.com/inward/record.url?scp=85193846610&partnerID=8YFLogxK

U2 - 10.1007/s41999-024-00989-w

DO - 10.1007/s41999-024-00989-w

M3 - Journal article

C2 - 38775876

SN - 1878-7649

VL - 15

SP - 1069

EP - 1080

JO - European Geriatric Medicine

JF - European Geriatric Medicine

IS - 4

ER -

Major comorbid diseases as predictors of infection in the first month after hip fracture surgery: a population-based cohort study in 92,239 patients

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