Risk factors for hypoxaemia following hip fracture surgery in elderly patients who recovered from COVID-19: a multicentre retrospective study

Wen Chi; Peng Pang; Zhenguo Luo; Xiaobing Liu; Wenbo Cai; Wangyang Li; Jianhong Hao

doi:10.3389/fmed.2023.1219222

Risk factors for hypoxaemia following hip fracture surgery in elderly patients who recovered from COVID-19: a multicentre retrospective study

Front Med (Lausanne). 2023 Jul 11:10:1219222. doi: 10.3389/fmed.2023.1219222. eCollection 2023.

Authors

Wen Chi¹, Peng Pang², Zhenguo Luo³, Xiaobing Liu³, Wenbo Cai³, Wangyang Li⁴, Jianhong Hao³

Affiliations

¹ Department of Operating Room, HongHui Hospital, Xi'an JiaoTong University, Xi'an, China.
² Department of Anaesthesiology, Binzhou Medical College Affiliated Hospital, Binzhou, China.
³ Department of Anaesthesiology, HongHui Hospital, Xi'an JiaoTong University, Xi'an, China.
⁴ Department of Orthopedic, Linfen Hospital Affiliated to Shanxi Medical University, Linfen, China.

Abstract

Objectives: To explore the risk factors associated with postoperative hypoxaemia in elderly patients who have recovered from coronavirus disease (COVID-19) and underwent hip fracture surgery in the short term.

Design: Multicentre retrospective study.

Setting: The study was performed in three first 3A-grade hospitals in China.

Participants: A sequential sampling method was applied to select study participants. Medical records of 392 patients aged ≥65 years who had recovered from COVID-19 and underwent hip fracture surgery at three hospitals in China between 1 November, 2022, and 15 February, 2023, were reviewed.

Interventions: Patients were assigned to hypoxaemia or non-hypoxaemia groups, according to whether hypoxaemia occurred after surgery. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for postoperative hypoxaemia.

Results: The incidence of postoperative hypoxaemia was 38.01%. Statistically significant differences were found between the two groups in terms of age, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, presence of expectoration symptoms, preoperative hypoxaemia, chronic obstructive pulmonary disease, pulmonary inflammation, time between recovery from COVID-19 and surgery, anaesthetic mode, surgical procedure, intraoperative blood loss, intraoperative infusion, duration of surgery, and length of hospital stay (p < 0.05). Furthermore, patients with BMI ≥28.0 kg/m², expectoration symptoms, presence of preoperative hypoxaemia, ASA classification III, time between recovery from COVID-19 and surgery ≤2 weeks, and general anaesthesia were potential risk factors for postoperative hypoxaemia.

Conclusion: Obesity, expectoration symptoms, preoperative hypoxaemia, ASA classification III, time between recovery from COVID-19 and surgery ≤2 weeks, and general anaesthesia were potential risk factors for postoperative hypoxaemia in elderly patients who recovered from COVID-19 and underwent hip fracture surgery in the short term.

Keywords: COVID-19; aged; hip fractures; hypoxia; risk.