Journal of Clinical Medicine Research

The objective is to screen and analyze independent risk factors related to postoperative complications in elderly patients with femoral neck fracture, so as to provide a theoretical basis for formulating targeted prevention strategies and improving clinical prognosis. A total of 124 elderly patients (aged ≥65 years) with femoral neck fracture who underwent surgical treatment in our hospital from January 2022 to December 2023 were enrolled in this retrospective study. According to whether postoperative complications occurred within 3 months after surgery, they were divided into a complication group (39 cases) and a non-complication group (85 cases). General data, preoperative comorbidities, laboratory indicators, fracture-related parameters, surgical and anesthesia-related indicators, and postoperative management data of the two groups were collected. Univariate chi-square test and multivariate logistic regression analysis were used to identify independent risk factors for postoperative complications. The overall incidence of postoperative complications was 31.45% (39/124), mainly including lower extremity deep vein thrombosis, pulmonary infection, urinary tract infection, postoperative delirium, anemia, hypoproteinemia, and acute kidney injury. Multivariate logistic regression analysis showed that age ≥80 years (OR=3.216, 95%CI: 1.524–6.782, P=0.002), at least two preoperative comorbidities (OR=4.153, 95%CI: 1.897–9.086, P<0.001), ASA grade Ⅲ–Ⅳ (OR=3.684, 95%CI: 1.655–8.197, P=0.001), preoperative hypoalbuminemia (albumin <35 g/L, OR=2.947, 95%CI: 1.326–6.541, P=0.008), preoperative anemia (hemoglobin <110 g/L, OR=2.753, 95%CI: 1.241–6.102, P=0.013), time from injury to surgery >48 hours (OR=2.869, 95%CI: 1.307–6.295, P=0.009), and operation time >90 minutes (OR=2.615, 95%CI: 1.184–5.773, P=0.018) were independent risk factors for postoperative complications in elderly patients with femoral neck fracture. The incidence of postoperative complications in elderly patients with femoral neck fracture is relatively high, and it is affected by a variety of factors. Clinicians should conduct comprehensive preoperative evaluation, optimize perioperative management, shorten the time to surgery, and strengthen postoperative monitoring for high-risk patients, so as to reduce the occurrence of complications and improve the quality of rehabilitation.