As the population of those age 80+ increases, surgeries for femur fractures will rise as well. A new 2-year retrospective cohort study in 479 patients (mean age 86 years) looked at the incidence and risk factors for common postoperative pulmonary complications—pneumonia, atelectasis, pulmonary edema, pleural effusion, and venous thromboembolism (VTE), as well as respiratory failure and 9-day mortality form a single hospital.
- Post-op complications occurred in 11.7%
- Pleural effusion was most common (4.4%) followed by pneumonia and atelectasis
- VTE occurred in 1.5%
- Patients who developed pulmonary complications had
- Longer hospital stays 14 days vs 10 days (P <0.001)
- Greater need for oxygen supplementation (71.4% vs 31.4%, P <0.001)
- Higher all-cause 90-day mortality (14.3% vs 5.9%, P = 0.042)
Age, chronic lung disease, and Parkinson’s disease were significant risk factors for pulmonary complications. Coronary artery disease, stroke, and prolonged surgery were significantly associated with respiratory failure, whereas internal fixation, coronary artery disease, and older age were associated with 90-day mortality. Distal femur fractures were significant risk factors for VTE, while VTE prophylaxis methods were not associated with VTE risk.
These findings highlight the importance of identifying comorbidities before surgery.
Source: Chai J, Kang J, Seo WJ, et al. Incidence and risk factors of pulmonary complications following femur fracture surgery in patients aged 80 years and older. Clin Interv Aging. 2024;19:1843-1854. https://doi.org/10.2147/CIA.S481641.
