Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca. España..
Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de Salamanca. Salamanca. España..
An Sist Sanit Navar. 2023 Apr 27;46(1):e1036. doi: 10.23938/ASSN.1036.
We assessed the relationship of estimated glomerular filtration rate values at hospital admission on the outcome of surgically treated older adults who had suffered a hip fracture.
Prospective study that included patients > 65 years of age, surgically treated for primary hip fracture, with no pathologic or high-energy trauma aetiology admitted to a tertiary teaching hospital between 2018 and 2019. We stratified patients based on their estimated glomerular filtration rate at admission and examined its association to demographic and clinical variables, including 90-day post-discharge mortality.
The study included 942 hip fracture patients. Lowered estimated glomerular filtration rate was significantly associated to a worsening of the functional status, higher incidence of medical postoperative complications, higher postoperative renal dysfunction, and greater number of blood transfusions. Mortality displayed a staircase pattern, increasing with decreasing estimated glomerular filtration rate. Patients with estimated glomerular filtration rate <60 had significantly higher mortality at 90 days after discharge. In-hospital mortality rate was 10.7% in hip fracture patients with chronic kidney disease who experienced a significant variation in the estimated glomerular filtration rate (>5 mL/min/1.73m2) on admission in comparison to baseline values.
Older adult patients treated for hip fracture with lower glomerular filtration rate values have poorer functional status and worse prognosis. A significant clinical variation of estimated glomerular filtration rate upon hospital admission for hip fracture may be associated with increased in-hospital mortality of chronic kidney disease patients.
我们评估了入院时估计肾小球滤过率（eGFR）值与接受髋关节骨折手术治疗的老年患者结局之间的关系。
前瞻性研究，纳入 2018 年至 2019 年期间在一所三级教学医院因原发性髋关节骨折接受手术治疗且无病理性或高能量创伤病因的年龄>65 岁的患者。我们根据入院时的估计肾小球滤过率对患者进行分层，并检查其与人口统计学和临床变量（包括 90 天出院后死亡率）的关系。
本研究共纳入 942 例髋关节骨折患者。降低的估计肾小球滤过率与功能状态恶化、更高的术后医疗并发症发生率、更高的术后肾功能障碍和更多的输血显著相关。死亡率呈阶梯式上升，随着估计肾小球滤过率的降低而增加。出院后 90 天估计肾小球滤过率<60 的患者死亡率显著升高。在因慢性肾脏病入院的髋关节骨折患者中，入院时估计肾小球滤过率（eGFR）值发生显著变化（>5 mL/min/1.73m2）与基线值相比，住院死亡率为 10.7%。
接受髋关节骨折治疗的老年患者，肾小球滤过率（eGFR）值越低，其功能状态越差，预后越差。髋关节骨折入院时估计肾小球滤过率（eGFR）的显著临床变化可能与慢性肾脏病患者住院死亡率的增加有关。
