ABSTRACT

Acute kidney injury (AKI) was a frequent complication following hip fracture surgery, but recent studies reported inconsistent findings. Our study was aimed at clarifying the prevalence and risk factors of AKI after hip fracture surgery. Pubmed, Embase, and Web of Science were systematically searched from the inception to March 2020 to identify observational studies investigating the prevalence and risk factors of AKI in patients undergoing hip fracture surgery. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using a random-effects model. Publication bias was evaluated with a funnel plot and statistical test. All the statistical analyses were performed using Stata version 12.0. A total of 11 studies with 16,421 patients was included in the current meta-analysis. The pooled prevalence of AKI in patients undergoing hip fracture surgery was 17% (95%CI, 14%-21%) with substantial heterogeneity (I² = 95%). Postoperative serum albumin (OR 1.80; 95%CI, 1.38–2.36) was a significant predictor for AKI. Age (OR 1.01; 95%CI, 0.95–1.07) and ACE inhibitors (OR 1.38; 95%CI, 0.92–2.07) were associated with increased the risk of AKI, but the results were not statistically significant. No significant publication bias was identified through statistical tests (Egger’s test, p = 0.258 and Begg’s test, p = 0.087). In conclusion, our findings indicated that the pooled AKI following hip fracture surgery was approximately 17%. Postoperative serum albumin was a potential significant risk factor for AKI.

摘要

急性肾损伤 (AKI) 是髋部骨折手术后常见的并发症，但最近的研究报告了不一致的结果。我们的研究旨在阐明髋部骨折手术后 AKI 的患病率和危险因素。从开始到 2020 年 3 月，系统地搜索了 Pubmed、Embase 和 Web of Science，以确定调查髋部骨折手术患者 AKI 患病率和危险因素的观察性研究。使用随机效应模型估计具有 95% 置信区间 (CI) 的汇总患病率和优势比 (OR)。发表偏倚通过漏斗图和统计检验进行评估。所有统计分析均使用 Stata 12.0 版进行。目前的荟萃分析共纳入了 11 项研究，涉及 16,421 名患者。²  = 95%）。术后血清白蛋白（OR 1.80；95%CI，1.38-2.36）是 AKI 的重要预测因子。年龄（OR 1.01；95%CI，0.95-1.07）和 ACE 抑制剂（OR 1.38；95%CI，0.92-2.07）与 AKI 风险增加相关，但结果无统计学意义。通过统计检验（Egger 检验，p = 0.258 和 Begg 检验，p = 0.087）未发现显着的发表偏倚。总之，我们的研究结果表明，髋部骨折手术后合并的 AKI 约为 17%。术后血清白蛋白是 AKI 潜在的重要危险因素。