Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2024; 15(4): 337-345
Published online Apr 18, 2024. doi: 10.5312/wjo.v15.i4.337
Effect of inflammatory response on joint function after hip fracture in elderly patients: A clinical study
Jia-Ming Wang, Yu-Tao Pan, Chen-Song Yang, Ming-Chong Liu, Sheng-Chao Ji, Ning Han, Fang Liu, Gui-Xin Sun
Jia-Ming Wang, Yu-Tao Pan, Chen-Song Yang, Ming-Chong Liu, Sheng-Chao Ji, Ning Han, Fang Liu, Gui-Xin Sun, Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
Co-first authors: Jia-Ming Wang and Yu-Tao Pan.
Co-corresponding authors: Gui-Xin Sun and Fang Liu.
Author contributions: Wang JM and Pan YT carried out the studies and drafted the manuscript; Sun GX and Liu F participated in the design of the study and conceived of the study; Yang CS and Liu MC contributed materials/analysis tools; Ji SC and Ning H performed the statistical analysis. All authors participated in the preparation of the manuscript.
Supported by Leading Talents Training Program of Pudong New Area Health Commission, No. PWR 12020-06; and Shanghai Science and Technology Commission, No. 20Y11901800.
Institutional review board statement: Shanghai East Hospital ethics committee reviewed and approved this research under the approval number: [2022] Research Audit No. 278.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gui-Xin Sun, PhD, Professor, Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, No. 150 Jimo Road, Shanghai 200092, China. sunguixin@tongji.edu.cn
Received: October 18, 2023
Peer-review started: October 18, 2023
First decision: January 17, 2024
Revised: January 27, 2024
Accepted: March 15, 2024
Article in press: March 15, 2024
Published online: April 18, 2024
Abstract
BACKGROUND

Excellent hip joint function facilitates limb recovery and improves the quality of survival. This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management.

AIM

To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients.

METHODS

The elderly patients who had hip fracture surgery at our hospital between January 1, 2021, and December 31, 2022 were chosen for this retrospective clinical investigation. Patients with excellent and fair postoperative hip function had their clinical information and characteristics gathered and compared. Age, gender, fracture site, surgical technique, laboratory indices, and other variables that could have an impact on postoperative joint function were all included in a univariate study. To further identify independent risk factors affecting postoperative joint function in hip fractures, risk factors that showed statistical significance in the univariate analysis were then included in a multiple logistic regression analysis. In addition to this, we also compared other outcome variables such as visual analogue scale and length of hospital stay between the two groups.

RESULTS

A total of 119 elderly patients with hip fractures were included in this study, of whom 37 were male and 82 were female. The results of univariate logistic regression analysis after excluding the interaction of various factors showed that there was a statistically significant difference in interleukin (IL)-6, IL-8, IL-10, C-reactive protein (CRP), and complement C1q (C1q) between the fair and excellent joint function groups (P < 0.05). The results of multiple logistic regression analysis showed that IL-6 > 20 pg/mL [(Odds ratio (OR) 3.070, 95%CI: 1.243-7.579], IL-8 > 21.4 pg/ mL (OR 3.827, 95%CI: 1.498-9.773), CRP > 10 mg/L (OR 2.142, 95%CI: 1.020-4.498) and C1q > 233 mg/L (OR 2.339, 95%CI: 1.094-5.004) were independent risk factors for poor joint function after hip fracture surgery (all P < 0.05).

CONCLUSION

After hip fractures in older patients, inflammatory variables are risk factors for fair joint function; therefore, early intervention to address these markers is essential to enhance joint function and avoid consequences.

Keywords: Hip function, Fracture, Inflammatory factors, Risk factors, Prevention

Core Tip: Interleukin (IL)-6 > 20 pg/mL, IL-8 > 21.4 pg/mL, C-reactive protein > 10 mg/L, and complement C1q (C1q) > 233 mg/L may be independent risk factors for fair postoperative joint function in patients with hip fracture. In addition, C1q represented a specific risk factor for fair joint function after hip fracture surgery in elderly patients, these predictors may provide a new strategy for the treatment of hip fracture.