The Association Between Preoperative Sepsis and the Mortality After Hip Fracture Surgery

Study Overview
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Brief Summary
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The worldwide occurrence of hip fracture is high with an annual incidence of approximately 100 per 100.000 people. Mortality for patients undergoing hip fracture surgery is high with a 30-day mortality rate varying between 4.5 and 13.3 %. It is agreed that non-modifiable factors such as age, gender and pre-existing comorbidities contribute to early death of hip fracture patients. However, not many studies have focused on preoperative sepsis as a potential risk factor. Hip fracture patients are commonly identified with sepsis after surgery, but the extent of preoperative sepsis and its consequences are sparsely elucidated. Being able to identify patients at higher risk of postoperative mortality could potentially improve outcome and extensive hospital registries of vital signs and cultures allow identification of preoperative sepsis. The aim of this study is to assess the association between preoperative sepsis and the 30-day mortality after hip fracture surgery.

Detailed Description
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This study will be a retrospective analysis of a set of data collected prospectively. Data on relevant cultures, blood samples, co-morbidities, time to surgery and 30-day mortality will be extracted from patient records and clinical databases to examine the pre- and postoperative status of the patients.

Official Title
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The Association Between Preoperative Sepsis and the Mortality After Hip Fracture Surgery

Conditions
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Sepsis, Hip Fractures

Intervention / Treatment
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* Procedure: Repair of hip fracture


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with one of the following ICD-10 diagnoses for hip fracture: DS720(Fracture of neck of femur), DS721 (Pertrochanteric fracture), DS721A(Intertrochanteric fracture), DS721B (Trochanteric fracture), DS722 (Subtrochanteric fracture) Patients who underwent surgery for hip fracture. Age > 18 years Exclusion Criteria: Patients with a pathologic hip fracture related to an underlying metastatic disease (ICD-10: DM907). Patients with incomplete preoperative data. All patients must have at least one record of each of the following variables within 72 hours prior to hip fracture surgery: temperature, heartrate, respiratory rate and blood leukocytes.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with preoperative sepsis<br>Sepsis defined as SIRS plus a positive culture from any site. | Procedure: Repair of hip fracture<br>* Patients undergoing hip fracture surgery<br>|
| Patients without preoperative sepsis<br> | Procedure: Repair of hip fracture<br>* Patients undergoing hip fracture surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality |  | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Admission to intensive care | yes/no | 30 days | 
| Length of hospital stay | in days | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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SIRS, systemic inflammatory response syndrome, Hip Fracture Surgery, Sepsis, Mortality