Diastolic dysfunction and acute kidney injury in elderly patients with femoral neck fracture

Woori Cho, Tae Yeon Hwang, Yoon Kyung Choi, Ji Hyun Yang, Myung-Gyu Kim, Sang Kyung Jo, Won Yong Cho, Se Won Oh

Research output: Contribution to journalArticle

Abstract

Background: Femoral neck fracture is common in the elderly population. Acute kidney injury (AKI) is an important risk factor for mortality in patients who have had such fracture. We evaluated the incidence of AKI in patients who had femoral neck fracture and identified risk factors for AKI and mortality. Methods: This was an observational cohort study including 285 patients who were ≥ 65 years of age and who underwent femoral neck fracture surgery between 2013 and 2017. Results: The mean age was 78.63 ± 6.75 years. A total of 67 (23.5%) patients developed AKI during the hospital stay: 57 (85.1%), 5 (7.5%), and 5 (7.5%) patients were classified as having stage 1, 2, and 3 AKI, respectively. Patients with AKI had a lower baseline estimated glomerular filtration rate and higher left atrial dimension, left ventricular mass index, pulmonary artery pressure, and the ratio of early mitral inflow velocity to early diastolic mitral annulus velocity (E/e’) and were more likely to have diabetes or hypertension (HTN) (P < 0.05). The presence of HTN (odds ratio [OR], 4.570; 95% confidence interval [CI], 1.632-12.797) higher E/e’ (OR, 1.105; 95% CI, 1.019-1.198), and lower hemoglobin (OR, 0.704; 95% CI, 0.528-0.938) were independently associated with a higher risk for developing AKI. Severe AKI (OR, 24.743; 95% CI, 2.822-212.401) was associated with a higher risk of mortality. Conclusion: Elderly patients with femoral neck fracture had a high incidence of AKI. Diastolic dysfunction was associated with AKI. Severe AKI was associated with in-hospital mortality.

Original languageEnglish
Pages (from-to)33-41
Number of pages9
JournalKidney Research and Clinical Practice
Volume38
Issue number1
DOIs
Publication statusPublished - 2019 Mar 1

Fingerprint

Femoral Neck Fractures
Acute Kidney Injury
Odds Ratio
Confidence Intervals
Mortality
Hypertension
Incidence
Hospital Mortality
Glomerular Filtration Rate
Pulmonary Artery
Observational Studies
Length of Stay
Hemoglobins
Cohort Studies

Keywords

  • Acute kidney injury
  • Diastolic heart failure
  • Femoral neck fractures

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

Diastolic dysfunction and acute kidney injury in elderly patients with femoral neck fracture. / Cho, Woori; Hwang, Tae Yeon; Choi, Yoon Kyung; Yang, Ji Hyun; Kim, Myung-Gyu; Jo, Sang Kyung; Cho, Won Yong; Oh, Se Won.

In: Kidney Research and Clinical Practice, Vol. 38, No. 1, 01.03.2019, p. 33-41.

Research output: Contribution to journalArticle

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abstract = "Background: Femoral neck fracture is common in the elderly population. Acute kidney injury (AKI) is an important risk factor for mortality in patients who have had such fracture. We evaluated the incidence of AKI in patients who had femoral neck fracture and identified risk factors for AKI and mortality. Methods: This was an observational cohort study including 285 patients who were ≥ 65 years of age and who underwent femoral neck fracture surgery between 2013 and 2017. Results: The mean age was 78.63 ± 6.75 years. A total of 67 (23.5{\%}) patients developed AKI during the hospital stay: 57 (85.1{\%}), 5 (7.5{\%}), and 5 (7.5{\%}) patients were classified as having stage 1, 2, and 3 AKI, respectively. Patients with AKI had a lower baseline estimated glomerular filtration rate and higher left atrial dimension, left ventricular mass index, pulmonary artery pressure, and the ratio of early mitral inflow velocity to early diastolic mitral annulus velocity (E/e’) and were more likely to have diabetes or hypertension (HTN) (P < 0.05). The presence of HTN (odds ratio [OR], 4.570; 95{\%} confidence interval [CI], 1.632-12.797) higher E/e’ (OR, 1.105; 95{\%} CI, 1.019-1.198), and lower hemoglobin (OR, 0.704; 95{\%} CI, 0.528-0.938) were independently associated with a higher risk for developing AKI. Severe AKI (OR, 24.743; 95{\%} CI, 2.822-212.401) was associated with a higher risk of mortality. Conclusion: Elderly patients with femoral neck fracture had a high incidence of AKI. Diastolic dysfunction was associated with AKI. Severe AKI was associated with in-hospital mortality.",
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AU - Cho, Woori

AU - Hwang, Tae Yeon

AU - Choi, Yoon Kyung

AU - Yang, Ji Hyun

AU - Kim, Myung-Gyu

AU - Jo, Sang Kyung

AU - Cho, Won Yong

AU - Oh, Se Won

PY - 2019/3/1

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N2 - Background: Femoral neck fracture is common in the elderly population. Acute kidney injury (AKI) is an important risk factor for mortality in patients who have had such fracture. We evaluated the incidence of AKI in patients who had femoral neck fracture and identified risk factors for AKI and mortality. Methods: This was an observational cohort study including 285 patients who were ≥ 65 years of age and who underwent femoral neck fracture surgery between 2013 and 2017. Results: The mean age was 78.63 ± 6.75 years. A total of 67 (23.5%) patients developed AKI during the hospital stay: 57 (85.1%), 5 (7.5%), and 5 (7.5%) patients were classified as having stage 1, 2, and 3 AKI, respectively. Patients with AKI had a lower baseline estimated glomerular filtration rate and higher left atrial dimension, left ventricular mass index, pulmonary artery pressure, and the ratio of early mitral inflow velocity to early diastolic mitral annulus velocity (E/e’) and were more likely to have diabetes or hypertension (HTN) (P < 0.05). The presence of HTN (odds ratio [OR], 4.570; 95% confidence interval [CI], 1.632-12.797) higher E/e’ (OR, 1.105; 95% CI, 1.019-1.198), and lower hemoglobin (OR, 0.704; 95% CI, 0.528-0.938) were independently associated with a higher risk for developing AKI. Severe AKI (OR, 24.743; 95% CI, 2.822-212.401) was associated with a higher risk of mortality. Conclusion: Elderly patients with femoral neck fracture had a high incidence of AKI. Diastolic dysfunction was associated with AKI. Severe AKI was associated with in-hospital mortality.

AB - Background: Femoral neck fracture is common in the elderly population. Acute kidney injury (AKI) is an important risk factor for mortality in patients who have had such fracture. We evaluated the incidence of AKI in patients who had femoral neck fracture and identified risk factors for AKI and mortality. Methods: This was an observational cohort study including 285 patients who were ≥ 65 years of age and who underwent femoral neck fracture surgery between 2013 and 2017. Results: The mean age was 78.63 ± 6.75 years. A total of 67 (23.5%) patients developed AKI during the hospital stay: 57 (85.1%), 5 (7.5%), and 5 (7.5%) patients were classified as having stage 1, 2, and 3 AKI, respectively. Patients with AKI had a lower baseline estimated glomerular filtration rate and higher left atrial dimension, left ventricular mass index, pulmonary artery pressure, and the ratio of early mitral inflow velocity to early diastolic mitral annulus velocity (E/e’) and were more likely to have diabetes or hypertension (HTN) (P < 0.05). The presence of HTN (odds ratio [OR], 4.570; 95% confidence interval [CI], 1.632-12.797) higher E/e’ (OR, 1.105; 95% CI, 1.019-1.198), and lower hemoglobin (OR, 0.704; 95% CI, 0.528-0.938) were independently associated with a higher risk for developing AKI. Severe AKI (OR, 24.743; 95% CI, 2.822-212.401) was associated with a higher risk of mortality. Conclusion: Elderly patients with femoral neck fracture had a high incidence of AKI. Diastolic dysfunction was associated with AKI. Severe AKI was associated with in-hospital mortality.

KW - Acute kidney injury

KW - Diastolic heart failure

KW - Femoral neck fractures

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