None listed
Conditions
Brief summary
Thromboembolic complications constitute significant causes of morbidity and mortality following hip fracture surgery. Ageing and obesity can independently increase the risk of thromboembolic complications. Patients at both extremes of BMI, both underweight and morbidly obese have the greatest risk of having fragility fractures. There is limited evidence on the cumulative effect of the two factors following orthopaedic surgery. Local reliable data on the extent of short- and long-term thromboembolic complications and VTE prophylaxis in this cohort are lacking. In addition, there has been extensive work on VTE following elective joint replacements; however, there is little literature on the role of BMI in postoperative thromboembolic outcomes in hip fracture patients. Our key research question is: What is the prevalence of thromboembolic complications in elderly patients undergoing hip fracture surgery and its association with clinicopathological factors including BMI. Our objective is to retrospectively review the incidence of short and long-term postoperative arterial and venous thromboembolic complications in patients at the Prince Charles Hospital before and after discharge and their association with BMI through database analysis and record linkage. For this data linkage study, details of the patients, 60 years and above that underwent hip fracture surgery at TPCH over a 10- year period (2010-2020) will be collected from Australian New Zealand Hip fracture registry (ANZ HFR), TPCH orthopaedic department data base as well as by individual chart review for missing or ambiguous details. We would exclude hip fracture patients that were not operated or those with co-existing fractures in other areas. Occurrence of complication will be retrieved from the orthopaedic database, from ANZ HFR from QH Statistical service branch (SSB) data linkage facility according to the data details and follow-up timepoints specified below. Diagnosis and complication codes are classified using the International Classification of Diseases, 10th Revision, Australian Modification (ICD-10-AM). Occurrence of postoperative complications will be retrieved from the orthopaedic database from regular follow up, ANZ HFR and QH Statistical service branch (SSB) data linkage facility for readmissions from QHAPDC (Queensland Hospital Admitted Patient Data Collection), representations from QNAPDC (Queensland Non-Admitted Patient Data Collection) and ED/clinic presentations, throughout the state and Mortality from Queensland Births Deaths and Marriages registry (QBDMR).
Interventions
Exposure: High or low body mass index (BMI) ( WHO classification) in hip fracture patients undergoing surgical fixation between January 2010 till 31 December 2020
The Prince Charles Hospital (TPCH) Hip Fracture unit was established in 2010 and manages approximately 350 hip fracture surgeries on average every year. Since 2015, Australian New Zealand Hip fracture registry (ANZHFR) was established as a collaborative project between societies with an aim to use the collected data to improve the out
Exposure: High or low body mass index (BMI) ( WHO classification) in hip fracture patients undergoing surgical fixation between January 2010 till 31 December 2020 The Prince Charles Hospital (TPCH) Hip Fracture unit was established in 2010 and manages approximately 350 hip fracture surgeries on average every year. Since 2015, Australian New Zealand Hip fracture registry (ANZHFR) was established as a collaborative project between societies with an aim to use the collected data to improve the outcomes through appropriate research. For this data linkage study, details of the patients that underwent hip fracture surgery at TPCH over a 10-year period (2010-2020) will be collected from various sources as below: Hospital admission records (TPCH orthopaedic department database) would contain information on demographics (age, gender, body height, weight, BMI, other nutritional assessment measures as available, namely from malnutritional screening tool, subjective global assessment score), comorbidities (history of venous thromboembolism (VTE), chronic obstructive pulmonary disease (COPD), congestive cardiac failure (CCF), coronary artery disease (CAD), Peripheral vascular disease, chronic kidney disease (CKD), dyslipidaemia, Obstructive sleep apnoea (OSA,) hypertension (HTN), diabetes mellitus (DM), liver and renal disease, smoking status, presence of cancer, treatment with opioids, anticoagulants, antibiotics, immunosuppression, presence of metabolic syndrome (MetS), laboratory parameters including serum albumin, functional status, American Society of Anaesthesiologists (ASA) classification, thromboprophylactic regimen, intraoperative details including tranexamic acid, time to surgery, time to mobilise and postoperative discharge details including length of hospital stay, intensive care unit stay, mortality and complications. MetS will be defined according to the International Diabetes Federation definition as obesity (BMI >30 kg/m2) + any two of raised triglycerides, reduced high density lipoprotein (HDL) cholesterol, raised blood pressure, raised fasting plasma glucose or their alternatives as described.
Sponsors
Usha Gurunathan
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult patients 60 years and above, who underwent surgery for hip fracture at TPCH between the years 2010-2020
Exclusion criteria
• Hip fracture patients who were managed with non-surgical options • Those with co-existing fractures in other areas
Outcome results
None listed