The impact of metabolic syndrome on 30-day outcomes in geriatric hip fracture surgeries

  • Azeem Tariq Malik
  • Carmen E. Quatman
  • Laura S. Phieffer
  • Thuan V. Ly
  • Jessica Wiseman
  • Safdar N. KhanEmail author
Original Article • HIP - FRACTURES



Past literature has reported metabolic syndrome (MetS) to complicate postoperative care in patients undergoing various surgical procedures. We sought to analyze the impact of MetS on 30-day outcomes following hip fracture surgeries in the geriatric population.

Materials and methods

The 2015–2016 ACS-NSQIP database was queried for patients undergoing hip fracture repair using CPT codes for total hip arthroplasty (27130), hemiarthroplasty (27125) and open reduction internal fixation (27236, 27244, 27245). Only patients ≥ 65 years of age undergoing surgery due to a traumatic hip fracture were included in the study. MetS was defined using preset criteria used by other NSQIP studies as the presence of—(1) diabetes mellitus AND (2) hypertension requiring medication AND (3) BMI ≥ 30 kg/m2.


Out of 31,621 patients, a total of 1388 (4.4%) geriatric patients with MetS underwent hip fracture surgery. Following adjusted analysis, the presence of MetS was associated with higher odds of a prolonged length of stay > 5 days (OR 1.14 [95% CI 1.01–1.29]; p = 0.031), deep SSI (OR 2.48 [95% CI 1.20–5.14]; p = 0.014), progressive renal insufficiency (OR 3.27 [95% CI 1.98–5.42]; p < 0.001), acute renal failure (OR 2.08 [95% CI 1.04–4.15]; p = 0.038), urinary tract infection (OR 1.43 [95% CI 1.12–1.81]; p = 0.004), 30-day readmissions (OR 1.28 [95% CI 1.08–1.52]; p = 0.005) and a non-home discharge (OR 1.42 [95% CI 1.18–1.71]; p < 0.001).


MetS is associated with a significantly increased risk of several postoperative complications, readmissions and non-home discharge dispositions. Providers can utilize these data to promote the need for better perioperative care in these high-risk patients.


Metabolic syndrome Hip fracture Geriatric Surgery Repair Outcomes NSQIP MetS Complications Readmissions 




Compliance with ethical standards

Conflict of interest

Authors Safdar N. Khan and Thuan Ly have received research grants from Spinal Kinetics.


The American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS-NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Azeem Tariq Malik
    • 1
  • Carmen E. Quatman
    • 1
  • Laura S. Phieffer
    • 1
  • Thuan V. Ly
    • 1
  • Jessica Wiseman
    • 1
  • Safdar N. Khan
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of OrthopaedicsThe Ohio State University Wexner Medical CenterColumbusUSA
  2. 2.The Benjamin R. and Helen Slack Wiltberger Endowed Chair in Orthopaedic Spine SurgeryWexner Medical Center at The Ohio State UniversityColumbusUSA
  3. 3.Department of Integrated Systems Engineering, Clinical Faculty, Spine Research InstituteWexner Medical Center at The Ohio State UniversityColumbusUSA

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