Abstract
Introduction
Rising incidence of fracture neck of femur (NOF) are associated with rising geriatric population. Majority of patients are suffering from comorbid factors. Impaired renal function is a common comorbid factor and most of the time it is attributed to an acute renal impairment following the fracture and surgery.
Objective of this study was to identify the effect of renal comorbid factors and their probable relative risk for a fracture and compare the results with Asian and European data. Specific objective was to identify a possibility of presence of pretraumatic subclinical chronic renal failure among fractured Sri Lankans.
Methodology
Data were collected from fractured patients (N=200) and non-fracture sample for a period of one year. Variables studied were, serum calcium, serum phosphate, blood hemoglobin level, blood urea and serum creatinine.
Data were analyzed using binary logistic and multiple regressions, principal component statistical technique using STATA software.
Results
The logistic regression of renal co morbid factors with fracture showed that relative risk of occurrence of higher blood urea (> 8.2 mmol/L) in a NOF patient is 3.35 times higher(p value 0.012), relative risks of occurrence of high serum creatinine (> 120 µmol/L) is 3.17 times higher(P value-0.027), risk of low hemoglobin (Hb < 12) is 2.58(p value 0.005) times higher than a non-fracture patient even after adjustments for blood loss following fracture. Results were compared with the Asian and European data.
Conclusions
Pretraumatic high blood urea, serum creatinine and low hemoglobin are associated with NOF Sri Lankan patients. Comparative Asian data shows higher figures in Sri Lanka. Studies in Nordic countries and Europe shows higher incidence of renal impairment in fracture neck of femur patients. Further studies are required to assess the presence of pretraumatic sub clinical chronic renal insufficiency in Sri Lanka and in European countries.
