Evidence map›Paper›PMID 32986156›Full record

ArticleArchives of orthopaedic and trauma surgery2021

Does preoperative hemodynamic preconditioning improve morbidity and mortality after traumatic hip fracture in geriatric patients? A retrospective cohort study.

J Q Kusen, P C R van der Vet, F J G Wijdicks, B C Link, B Poblete, D van der Velde, R Babst, F J P Beeres

Abstract read
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In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Beyond the Clock: Understanding Delays in Hip Fracture Surgery.Geriatric orthopaedic surgery & rehabilitation · 2026
    Article
  2. Liberal intraoperative fluid management leads to increased complication rates in geriatric patients with hip fracture.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

J Q KusenKlinik für Orthopädie Und Unfallchirurgie, Luzerner Kantonsspital, Spitalstrasse, 6000, Lucerne, Switzerland.ORCID http://orcid.org/0000-0003-1543-4840
P C R van der VetKlinik für Orthopädie Und Unfallchirurgie, Luzerner Kantonsspital, Spitalstrasse, 6000, Lucerne, Switzerland.
F J G WijdicksDepartment of Surgery, Diakonessenhuis, Utrecht, The Netherlands.
B C LinkKlinik für Orthopädie Und Unfallchirurgie, Luzerner Kantonsspital, Spitalstrasse, 6000, Lucerne, Switzerland.
B PobleteKlinik für Anästhesie, Luzerner Kantonsspital, Spitalstrasse, 6000, Lucerne, Switzerland.
D van der VeldeDepartment of Surgery, St. Antoniusziekenhuis, Utrecht, The Netherlands.
R BabstKlinik für Orthopädie Und Unfallchirurgie, Luzerner Kantonsspital, Spitalstrasse, 6000, Lucerne, Switzerland.
F J P BeeresKlinik für Orthopädie Und Unfallchirurgie, Luzerner Kantonsspital, Spitalstrasse, 6000, Lucerne, Switzerland. frank.beeres@luks.ch.
Luzerner Kantonsspital · CHDiakonessenhuis hospital · NLSt. Antonius Ziekenhuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDehydration is a major problem in the older population with traumatic hip fractures (THF). A preoperative hemodynamic preconditioning (PHP) protocol may help in achieving hemodynamic stability to ensure adequate perfusion and oxygenation using only clinical parameters to assess cardiovascular performance. MATERIALS AND

methodsA single-centre retrospective study in geriatric trauma patients was conducted in a Level 1 Trauma Centre in Switzerland. Patients over the age of 70 with THFs and with Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality (P-POSSUM) scores ≥ 5% who underwent surgical treatment between February 2015 and October 2017 were included. It was hypothesized that patients whose hemodynamic stability was optimised before surgery would have fewer complications and reduced mortality postoperatively. Primary outcomes were complications and mortality. Secondary outcomes were hospital length of stay (HLOS) and place of discharge.

results100 patients were included in the PHP group and 79 patients were included in the non-PHP group. The median age was 86.5 (82-90) in the PHP group and 86 (82-90) in the non-PHP group. Patients who had been treated according to the PHP protocol showed a significant reduction in mortality at 30 days (p = 0.02). The PHP group showed an 8.1 and 3.5% reduced mortality at 90 days and at 1 year, respectively. The PHP group showed an 11.7% reduction of patients with complicated courses. No significant differences were seen in HLOS and discharge disposition.

conclusionsThe PHP group showed a significant reduction in short-term mortality, a reduction in long-term mortality, and a reduction in the number of patients with complicated courses. The PHP protocol is a safe, strictly regulated, non-invasive fluid resuscitation protocol for the optimization of geriatric patients with a THF that requires minimal effort. LEVEL OF EVIDENCE: Level III, therapeutic.

Indexed as

Hip FracturesAged, 80 and overHemodynamicsHumansLength of StayMorbidityRetrospective StudiesFluid resuscitationGeriatricHip fracturePerioperative fluidsPostoperative complications

Identifiers

PMID32986156
OpenAlexW3089134997

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.