A Meta-Analysis of Acute Kidney Injury in Patients Undergoing Hip Fracture Surgery: Prevalence and Risk Factors

Objective: Acute kidney injury(AKI) was a frequent complication following hip fracture surgery, but recent studies reported inconsistent findings. The purpose of our study was to systematically clarify the prevalence and risk factors of AKI after hip fracture surgery. Methods: Pubmed, Embase, and Web of Science were searched from the inception to March 2020 to identify observational studies investigating the prevalence and risk factors of AKI in patients undergoing hip fracture surgery. Pooled prevalence and odds ratios(ORs) with 95% confidence intervals(CIs) were estimated using random-effect model. Publication bias was evaluated with a funnel plot and statistical test. All the statistical analyses were performed using STATA version 12.0. Results: A total of 11 studies with 16,421 patients were included in the current meta-analysis. The pooled prevalence of AKI in patients undergoing hip fracture surgery was 17%(95%CI, 14%-21%). Postoperative serum albumin(OR 1.80; 95%CI, 1.38–2.36) was a significant predictor for AKI. Age(OR 1.01; 95%CI, 0.95–1.07) and ACE inhibitors(OR 1.38; 95%CI, 0.92–2.07) were also associated with increased risk of AKI, but the results were not statistically significant. No significant publication bias was identified through statistical tests(Egger’s test, p = 0.258 and Begg’s test, p = 0.087). Conclusions: The pooled AKI following hip fracture surgery was approximately 17%. Postoperative serum albumin was a potential significant risk factor for AKI.