Acute cholecystitis after hip fracture tied to excess mortality in elderly

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Takeaway

  • Acute cholecystitis occurring within 30 days after hip fracture in the elderly has an incidence of 0.24% and increases the mortality rate 4-fold.

Why this matters

  • First study to examine the incidence of acute cholecystitis after hip fracture and its mortality consequences.
  • Findings suggest that early detection and management of acute cholecystitis in this population is warranted.

Study design

  • Retrospective cohort of patients with hip fracture undergoing surgery (n=15,210) drawn from a 10% sample of the Korean National Health Insurance Service-Senior cohort of about 5.5 million enrollees >60 years.
  • Funding: None disclosed.

Key results

  • 51.9% of the cohort were undergoing surgery for femoral neck fracture; 48.9% had hemiarthroplasty.
  • 30-day incidence of acute cholecystitis in the hip fracture cohort was 36 of 15,210, or 0.24%.
  • 30-day mortality rate was 4 (11.1%) of 36 vs 2.92% of hip fracture patients without cholecystitis.
    • The adjusted risk ratio for mortality was 4.35 (P=.003) in the multivariate adjusted Poisson regression model.

Limitations

  • Retrospective observational design.
  • Reliance on claims database.