Preoperative leukocytosis and postoperative outcomes in geriatric hip fracture patients: a retrospective cohort study

Abstract

Background: A growing amount of evidence has suggested an association between preoperative leukocytosis and postoperative complications across a variety of surgeries. The aim of this study was to evaluate the impact of preoperative leukocytosis on the prognosis of geriatric patients with hip fracture after surgery. Methods: This retrospective cohort included 1007 patients age 65 yr and older who underwent surgery for hip fracture between January 2016 and December 2019 at a district general hospital. Outcomes measured included surgical-site infection and 30-day and 1-year mortality. A multivariate logistic regression model was constructed in order to test whether leukocytosis was an independent predictor of morbidity and mortality in patients with hip fracture. Results: After adjustment for covariates, leukocytosis was not found to be a significant independent predictor of poor outcome after geriatric hip-fracture surgery. Delay of surgery longer than 48 hr and dementia were found to be independent variables associated with increased risk of surgical-site infection. The predictors of 30-day mortality were male gender and the use of anticoagulant or antiaggregant medications, whereas male gender, delay of surgery more than 48 hr, dementia and hypoalbuminemia were associated with increased 1-year mortality. Conclusions: Preoperative leukocytosis was not associated with adverse postoperative outcome after geriatric hip-fracture surgery. The more reliable variables for prediction of surgical outcome in geriatric patients with hip fracture were delay in surgery, gender, hypoalbuminemia, dementia, and use of anticoagulant or antiaggregant medications. Level of Evidence: Level III.