Clinical Characteristics and Influencing Factors of Perioperative Pneumonia in Elderly Hip Fracture Patients (Aged ≥80 Years) at a Tertiary Hospital in Beijing

Objective To analyze and summarize the clinical characteristics of perioperative pneumonia in elderly patients with hip fractures, and to explore the influencing factors for the occurrence and severity of perioperative pneumonia.Methods The demographic and clinical data of elderly patients aged ≥ 80 years with hip fractures admitted to Beijing Jishuitan Hospital, Capital Medical University from January 2014 to December 2022 were retrospectively analyzed. Univariate and multivariate logistic regression models were used to analyze the influencing factors for the occurrence of perioperative pneumonia and its progression to severe cases.Results A total of 1,326 elderly patients undergoing hip fracture surgery were included in the study. The median age was 88 (84-93) years. Among them, 681 patients developed perioperative pneumonia, and 114 cases progressed to severe pneumonia. Multivariate regression analysis showed that advanced age, male gender, smoking history, a long interval between fracture occurrence and surgery, and general anesthesia were possible independent risk factors for the occurrence of perioperative pneumonia. At the same time, increased creatinine, decreased peripheral blood lymphocyte ratio, and decreased albumin were also associated with the incidence of perioperative pneumonia. Analysis of severe and non-severe pneumonia showed that patients with a history of diabetes, higher peripheral blood neutrophil percentage, B-type natriuretic peptide, and procalcitonin, as well as lower peripheral blood lymphocyte ratio, albumin, and arterial oxygenation index were more likely to progress to severe pneumonia.Conclusion Advanced age, male gender, a history of smoking, a long interval between fracture occurrence and surgery, and general anesthesia are possible independent risk factors for the occurrence of perioperative pneumonia in elderly patients undergoing hip fracture surgery. Moreover, the decrease in peripheral blood lymphocytes and albumin, as well as a previous history of diabetes, are all high-risk factors for the occurrence and progression of perioperative pneumonia.[Key Words] Hip Fracture, Perioperative Pneumonia, Geriatric, Clinical Characteristics