Title : Analysis of risk factors and preventive strategies for perioperative pneumonia in elderly patients with hip fracture-1
Abstract:
Pneumonia is a serious complication after hip fracture surgery and the leading risk factor for 30-day mortality in this vulnerable population. Identifying modifiable perioperative factors may help improve outcomes in fragile elderly patients aged 80 years or older. We retrospectively reviewed in-hospital data of patients aged ≥80 years who underwent hip fracture surgery at Beijing Jishuitan Hospital between January 1 and November 31, 2014. Patients were divided into a perioperative pneumonia (POP) group and a non-POP group. Logistic regression models were used to identify independent risk factors, with statistical significance set at p < 0.05. The incidence of POP was 11.3% (33/293). Male patients had a significantly higher POP rate than females (20.83% vs. 6.6%, p < 0.001). At baseline, the POP group showed higher neutrophil percentages (78.15% ± 9.16% vs. 81.96% ± 6.14%, p = 0.033) and lower albumin levels (p = 0.039). Multivariate logistic regression identified male gender (OR = 3.402, p = 0.048), low albumin (OR = 10.16, p = 0.001), and low PaO? (OR = 2.916, p = 0.007) as independent risk factors for POP. Based on these findings, our hospital launched the "Yangfan (Sailing) Program", a quality improvement initiative focused on elderly hip fracture care. A core component of this program is prioritizing early surgical intervention for these patients. Our preliminary data show that reducing time-to-surgery significantly decreases perioperative complications, including pneumonia, and improves long-term functional outcomes and quality of life in this high-risk population.
