The high-risk hip fracture patient and the palliative care consult : A retrospective study to investigate risks of complications and the utility of a palliative care consult in hip fracture patients undergoing surgical fixation
Authors' conclusion
Obtaining a PCC can reflect risks of complications and mortality.
Study context
- Population
- Patients with surgically managed hip fracture, Level I academic trauma center
- Participants
- 462 patients
- Exposure
- Pre-operative palliative care consult vs no palliative care consult (PCC)
- Outcome
- Risk factors for post-surgical complications and utility of a PCC, particularly regarding time to the OR
Methodological detailssingle-centre, Level I academic trauma center, multivariate analysis
- Single-centre
- Level I academic trauma center
- Multivariate analysis
Main finding
As reported in the abstract
Independent risk factors for post-surgical complications
Decreased pre-injury ambulatory status: OR (95% CI), p
2.18
1.13–4.20p = .02
Time to OR > 48 h: OR (95% CI), p
4.76
1.43–15.87p = .011
Pre-operative PCC: OR (95% CI), p
3.03
1.34–6.85p = .008
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Factors associated with delay to surgery >48 h | 5.5 (1.4–22.7) | P = 0.017 | |
| 0.050.21520Odds ratio (log scale) |
- Factors associated with delay to surgery >48 h — Male sex: OR (CI), p
- 4.6 (1.4-15.0), p = .013
Multivariate risk factors for obtaining a PCC
- Older age: OR (CI), p
- 1.1 (1.0-1.1), p = .007
- Pre-injury ambulatory status: OR (CI), p
- 2.2 (1.3-3.9), p = .005
- Renal failure: OR (CI), p
- 3.1 (1.1-9.0), p = 0.032
- Higher ASA category: OR (CI), p
- 2.6 (1.2-5.5), p = .014
Original publication
The high-risk hip fracture patient and the palliative care consult : A retrospective study to investigate risks of complications and the utility of a palliative care consult in hip fracture patients undergoing surgical fixation. Osteoporos Int. Published 14 December 2022. doi:10.
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