Patients with diabetes on dialysis had greatest readmission, mortality risks after hip fracture surgery

In a study of patients with diabetes who underwent hip fracture fixation surgery, investigators found patients on dialysis had the greatest risk for readmission and mortality compared to patients with CKD and those without CKD.

In addition, they found patients with CKD were at greater risk for readmission and mortality patients vs. patients without CKD but these groups had comparable risks for revision and infection.

“Clinicians should pay particular attention to the perioperative care of individuals with impaired kidney function,” the researchers wrote.

Researchers included 44,065 patients with diabetes who were either were receiving dialysis, had CKD or did not have CKD. All patients received osteosynthesis for hip fracture between January 1997 and December 2013. Primary outcomes included infection and revision surgery. Secondary outcomes were all-cause readmission and mortality.

Researchers found patients on dialysis had a higher risk of developing infection or needing revision surgery when compared to both the CKD and non-CKD diabetic groups. The risk of surgical complications, including infection and revision, were comparable in patients with diabetes and CKD vs. patients with diabetes but not CKD.

“High fracture incidences and poor fracture healing were the two main problems for patients in this study,” the authors wrote. “Patients with CKD mostly have problems in calcium metabolism and bone mineralization. Malnutrition, anemia and chronic kidney disease-mineral and bone disorder are potential risk factors affecting bony union in CKD patients.”

Additionally, researchers found the dialysis group had the greatest risk of the three groups for readmission and mortality. The diabetic CKD group had a statistically higher risk of readmission and mortality compared to the non-diabetic group. – by Scott Buzby

Disclosures: The authors report no relevant financial disclosures

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Source:

Huang P, et al. J Bone Miner Res.2019;doi:10.1002/jbmr.3663.