{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:03:11Z","timestamp":1784534591843,"version":"3.55.0"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Geriatr Orthop Surg Rehabil"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In-hospital mortality following hip fracture surgery remains a significant outcome in elderly patients, yet perioperative determinants \u2014 particularly those modifiable during hospitalization \u2014 are incompletely characterized. Whether the prognostic impact of acute kidney injury (AKI) on in-hospital mortality differs according to fracture type has not been previously examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 342 patients aged \u226565 years who underwent surgical treatment for hip fracture at a tertiary referral center between January 2018 and January 2022. The primary outcome was in-hospital mortality. Independent predictors were identified using multivariable logistic regression. Model performance was assessed by ROC analysis, Hosmer\u2013Lemeshow calibration testing, and bootstrap internal validation with 1000 iterations. A simple additive risk score was derived from the final model. Interaction analysis evaluated whether fracture type modified the association between AKI and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In-hospital mortality occurred in 29 of 342 patients (8.5%). Independent predictors were postoperative AKI (OR 5.46, 95% CI 2.20\u201313.51), lower preoperative serum albumin (OR per 1 g\/dL increase 0.38, 95% CI 0.18\u20130.78), and lower admission oxygen saturation (OR per 1% increase 0.86, 95% CI 0.77\u20130.95). The model demonstrated acceptable discrimination (AUC = 0.766, 95% CI 0.655\u20130.877). A three-variable additive risk score stratified mortality from 3.4% (score 0) to 39.1% (score 2\u20133). Interaction analysis revealed that fracture type significantly modified the prognostic impact of AKI (interaction p = 0.016), with a substantially stronger effect in extracapsular fractures (OR 14.3, 95% CI 4.0\u201350.0) than intracapsular fractures (OR 1.32, 95% CI 0.30\u20135.88).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Postoperative AKI, hypoalbuminemia, and reduced admission oxygen saturation independently predict in-hospital mortality after hip fracture surgery. The mortality risk conferred by AKI is substantially greater in extracapsular fractures, highlighting the need for fracture-type\u2013specific perioperative vigilance and early renal protection strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21514593261461131","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:14:24Z","timestamp":1784366064000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Fracture Type Modifies the Prognostic Impact of Acute Kidney Injury on In-Hospital Mortality after Hip Fracture Surgery in Elderly Patients: A Retrospective Cohort Study with Risk Stratification"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3119-5432","authenticated-orcid":false,"given":"Ozan","family":"Altun","sequence":"first","affiliation":[{"name":"\u00c7ank\u0131r\u0131 State Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdi","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman","family":"\u00c7\u00f6mez","sequence":"additional","affiliation":[{"name":"Karab\u00fck University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y\u0131lmaz","family":"Ergi\u015fi","sequence":"additional","affiliation":[{"name":"Karab\u00fck University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uygar","family":"Da\u015far","sequence":"additional","affiliation":[{"name":"Karab\u00fck University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed Nadir","family":"Yal\u00e7\u0131n","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Karab\u00fck Private Medikar Hospital, Karabuk, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01623184"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2022.12.008"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001025"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1120700019835160"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001026"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.recot.2017.03.003"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/21514593211044644"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.07.501"},{"issue":"1","key":"e_1_3_7_10_2","first-page":"1","article-title":"KDIGO Clinical Practice Guideline for Acute Kidney Injury","volume":"2","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group","year":"2012","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. 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