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- Ylinenvaara, Sandra I, et al.
(författare)
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Preoperative urine-specific gravity and the incidence of complications after hip fracture surgery : A prospective, observational study
- 2014
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Ingår i: European Journal of Anaesthesiology. - : Lippincott Williams & Wilkins. - 0265-0215 .- 1365-2346. ; 31:2, s. 85-90
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mild to moderately severe dehydration is common in the elderly, but its relationship to surgical outcome is unclear.OBJECTIVES: To study the incidence of dehydration prior to hip fracture surgery and its relationship to postoperative complications.DESIGN: Prospective observational study.SETTING: Operation department and orthopaedic ward at a regional hospital.PATIENTS: Forty-five patients [median (interquartile range) age 78 (75 to 86) years] undergoing acute hip fracture surgery.INTERVENTIONS: A urine sample was taken on admission to the operating theatre. Complications were assessed 2 days postoperatively using a check-list.MAIN OUTCOME MEASURES: Dehydration was considered to be present if the urinary specific gravity was 1.020 or higher, indicating renal water conservation. The number and type of postoperative complications were recorded.RESULTS: Dehydration was present in one third of the patients. Sixty percent of these patients had at least one postoperative complication, whereas the corresponding proportion was 30% in the euhydrated patients (P <0.01). Only one patient (3%) had more than one complication in the euhydrated group compared with six patients (40%) in the dehydrated group (P <0.01). Euhydrated patients had a mean of 0.3 postoperative complications per surgery, whereas dehydrated patients scored 1.1 complications (P <0.015). The higher incidence included confusion, arterial desaturation and cardiovascular events.CONCLUSION: Dehydration before surgery nearly quadrupled the number of postoperative complications after hip fracture repair.
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