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 hip-fracture patients 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 hip-fracture patients. 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 hip-fracture patients were delay in surgery, gender, hypoalbuminemia, dementia, and use of anticoagulant or antiaggregant medications. Level of Evidence: Level III.