Kidney Res Clin Pract.  2019 Mar;38(1):33-41. 10.23876/j.krcp.18.0083.

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

• Cho W
• Hwang TY
• Choi YK
• Yang JH
• Kim MG
• Jo SK
• Cho WY
• Oh SW

• KMID: 2447142
• DOI: http://doi.org/10.23876/j.krcp.18.0083

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.

Keyword

Acute kidney injury; Diastolic heart failure; Femoral neck fractures

MeSH Terms

Acute Kidney Injury*
Aged*
Cohort Studies
Femoral Neck Fractures*
Femur Neck*
Glomerular Filtration Rate
Heart Failure, Diastolic
Hospital Mortality
Humans
Hypertension
Incidence
Length of Stay
Mortality
Pulmonary Artery
Risk Factors