Preoperative status and risk of complications in patients with hip fracture

Mary Ann McLaughlin, Gretchen M. Orosz, Jay Magaziner, Edward L. Hannan, Thomas McGinn, R. Sean Morrison, Tsivia Hochman, Kenneth Koval, Marvin Gilbert, Albert L. Siu

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


BACKGROUND: Limited information is available on preoperative status and risks for complications for older patients having surgery for hip fracture. Our objective was to identify potentially modifiable clinical findings that should be considered in decisions about the timing of surgery. METHODS: We conducted a prospective cohort study with data obtained from medical records and through structured interviews with patients. A total of 571 adults with hip fracture who were admitted to 4 metropolitan hospitals were included. RESULTS: Multiple logistic regression was used to identify risk factors (including 11 categories of physical and laboratory findings, classified as mild and severe abnormalities) for in-hospital complications. The presence of more than 1 (odds ratiol [OR] 9.7, 95% confidence interval [CI] 2.8 to 33.0) major abnormality before surgery or the presence of major abnormalities on admission that were not corrected prior to surgery (OR 2.8, 95% CI 1.2 to 6.4) was independently associated with the development of postoperative complications. We also found that minor abnormalities, while warranting correction, did not increase risk (OR 0.70, 95% CI 0.28 to 1.73). CONCLUSIONS: In this study of older adults undergoing urgent surgery, potentially reversible abnormalities in laboratory and physical examination occurred frequently and significantly increased the risk of postoperative complications. Major clinical abnormalities should be corrected prior to surgery, but patients with minor abnormalities may proceed to surgery with attention to these medical problems perioperatively.

Original languageEnglish
Pages (from-to)219-225
Number of pages7
JournalJournal of General Internal Medicine
Issue number3
StatePublished - Mar 2006


  • Complications
  • Elderly
  • Hip fracture
  • Noncardiac surgery
  • Preoperative assessment


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