Cecilia Majlund Hansen, Nadia R Gadgaard, Christina Vandenbroucke-Grauls, Nils P Hailer, Alma Becic Pedersen
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We computed incidence rates (IR) of any kind of hospital-treated infection within 1 month and 1 year with 95% confidence intervals and estimated the attributable proportion (in %) based on differences in IRs.</p><p><strong>Results: </strong>The IR of infection within 1 month was 181 (176-186) per 100 person years in HF patients with no multimorbidity and 9 (95% CI 8-9) in the comparison cohort with no multimorbidity. The IRs were 240 (234-246) and 302 (291-313) in HF patients with moderate and severe multimorbidity compared with 17 (16-18) and 31 (30-33) in the comparison cohort with same multimorbidity level. The attributable proportion indicates that 21% and 33% of the IR among HF patients with moderate and severe multimorbidity, respectively, was explained by interaction. Similar interactions were observed within 1 year.</p><p><strong>Conclusion: </strong>Multimorbidity and HF surgery interact synergistically, which substantially increases the infection risk. The interaction effect increased with multimorbidity level. Our findings highlight the potential benefits of implementing more targeted and personalized preventive initiatives for multimorbid patients.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"17 ","pages":"167-176"},"PeriodicalIF":3.4000,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869750/pdf/","citationCount":"0","resultStr":"{\"title\":\"Interaction Between Multimorbidity and Hip Fracture Surgery Leads to Excess Risk of Infection: A Danish Registry-Based Cohort Study of 92,599 Patients With Hip Fracture.\",\"authors\":\"Cecilia Majlund Hansen, Nadia R Gadgaard, Christina Vandenbroucke-Grauls, Nils P Hailer, Alma Becic Pedersen\",\"doi\":\"10.2147/CLEP.S507252\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Infection in general is a frequent and serious complication after hip fracture (HF) surgery. Multimorbidity in HF patients is associated with elevated infection risk. It remains unclear whether multimorbidity interacts with HF surgery to increase infection risk beyond their individual effects.</p><p><strong>Methods: </strong>Using Danish registries, we identified 92,599 patients ≥65 years surgically treated for HF 2004 to 2018 and an age- and sex-matched comparison cohort from the background population without HF (n=462,993). Multimorbidity was defined using the Charlson Comorbidity Index in categories no, moderate, or severe. We computed incidence rates (IR) of any kind of hospital-treated infection within 1 month and 1 year with 95% confidence intervals and estimated the attributable proportion (in %) based on differences in IRs.</p><p><strong>Results: </strong>The IR of infection within 1 month was 181 (176-186) per 100 person years in HF patients with no multimorbidity and 9 (95% CI 8-9) in the comparison cohort with no multimorbidity. The IRs were 240 (234-246) and 302 (291-313) in HF patients with moderate and severe multimorbidity compared with 17 (16-18) and 31 (30-33) in the comparison cohort with same multimorbidity level. The attributable proportion indicates that 21% and 33% of the IR among HF patients with moderate and severe multimorbidity, respectively, was explained by interaction. Similar interactions were observed within 1 year.</p><p><strong>Conclusion: </strong>Multimorbidity and HF surgery interact synergistically, which substantially increases the infection risk. The interaction effect increased with multimorbidity level. 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引用次数: 0
摘要
目的:感染是髋部骨折术后常见且严重的并发症。心衰患者的多重发病与感染风险升高有关。目前尚不清楚多种疾病是否会与心衰手术相互作用,增加感染风险。方法:使用丹麦的注册表,我们从2004年至2018年的92599例≥65岁的HF手术患者和年龄和性别匹配的无HF背景人群(n= 462993)中筛选出比较队列。多重病的定义采用Charlson共病指数分为无、中度和重度。我们以95%的置信区间计算了1个月和1年内任何一种医院治疗感染的发病率(IR),并根据IR的差异估计了归因比例(以%为单位)。结果:1个月内感染的IR在无多病的HF患者中为181(176-186)/ 100人年,在无多病的对照组中为9 (95% CI 8-9)。中度和重度多重发病的HF患者的IRs分别为240(234-246)和302(291-313),而相同多重发病水平的对照队列的IRs分别为17(16-18)和31(30-33)。归因比例表明,在中度和重度多病HF患者中,分别有21%和33%的IR可以通过相互作用来解释。在1年内观察到类似的相互作用。结论:多发病与心衰手术相互作用,显著增加感染风险。交互作用随多病程度的增加而增加。我们的研究结果强调了对多病患者实施更有针对性和个性化的预防措施的潜在益处。
Interaction Between Multimorbidity and Hip Fracture Surgery Leads to Excess Risk of Infection: A Danish Registry-Based Cohort Study of 92,599 Patients With Hip Fracture.
Purpose: Infection in general is a frequent and serious complication after hip fracture (HF) surgery. Multimorbidity in HF patients is associated with elevated infection risk. It remains unclear whether multimorbidity interacts with HF surgery to increase infection risk beyond their individual effects.
Methods: Using Danish registries, we identified 92,599 patients ≥65 years surgically treated for HF 2004 to 2018 and an age- and sex-matched comparison cohort from the background population without HF (n=462,993). Multimorbidity was defined using the Charlson Comorbidity Index in categories no, moderate, or severe. We computed incidence rates (IR) of any kind of hospital-treated infection within 1 month and 1 year with 95% confidence intervals and estimated the attributable proportion (in %) based on differences in IRs.
Results: The IR of infection within 1 month was 181 (176-186) per 100 person years in HF patients with no multimorbidity and 9 (95% CI 8-9) in the comparison cohort with no multimorbidity. The IRs were 240 (234-246) and 302 (291-313) in HF patients with moderate and severe multimorbidity compared with 17 (16-18) and 31 (30-33) in the comparison cohort with same multimorbidity level. The attributable proportion indicates that 21% and 33% of the IR among HF patients with moderate and severe multimorbidity, respectively, was explained by interaction. Similar interactions were observed within 1 year.
Conclusion: Multimorbidity and HF surgery interact synergistically, which substantially increases the infection risk. The interaction effect increased with multimorbidity level. Our findings highlight the potential benefits of implementing more targeted and personalized preventive initiatives for multimorbid patients.
期刊介绍:
Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment.
Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews.
Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews.
When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes.
The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.