The impact of metabolic syndrome on 30-day outcomes in geriatric hip fracture surgeries.

Abstract

Past literature has reported metabolic syndrome (MetS) to complicate postoperative care in patients undergoing various surgical procedures. We sought to analyze the impact of MetS on 30-day outcomes following hip fracture surgeries in the geriatric population. The 2015-2016 ACS-NSQIP database was queried for patients undergoing hip fracture repair using CPT codes for total hip arthroplasty (27130), hemiarthroplasty (27125) and open reduction internal fixation (27236, 27244, 27245). Only patients ≥ 65 years of age undergoing surgery due to a traumatic hip fracture were included in the study. MetS was defined using preset criteria used by other NSQIP studies as the presence of-(1) diabetes mellitus AND (2) hypertension requiring medication AND (3) BMI ≥ 30 kg/m². Out of 31,621 patients, a total of 1388 (4.4%) geriatric patients with MetS underwent hip fracture surgery. Following adjusted analysis, the presence of MetS was associated with higher odds of a prolonged length of stay > 5 days (OR 1.14 [95% CI 1.01-1.29]; p = 0.031), deep SSI (OR 2.48 [95% CI 1.20-5.14]; p = 0.014), progressive renal insufficiency (OR 3.27 [95% CI 1.98-5.42]; p < 0.001), acute renal failure (OR 2.08 [95% CI 1.04-4.15]; p = 0.038), urinary tract infection (OR 1.43 [95% CI 1.12-1.81]; p = 0.004), 30-day readmissions (OR 1.28 [95% CI 1.08-1.52]; p = 0.005) and a non-home discharge (OR 1.42 [95% CI 1.18-1.71]; p < 0.001). MetS is associated with a significantly increased risk of several postoperative complications, readmissions and non-home discharge dispositions. Providers can utilize these data to promote the need for better perioperative care in these high-risk patients.