Concurrent surgery for hip fractures associated with greater complication risk than non-concurrent surgery

SAN DIEGO — Hip fractures managed concurrently had an increased early complications risk and late complications risk compared with hip fractures managed non-concurrently, according to a presenter, here.

“[Looking] at complications within 90 days, we found concurrent patients did have approximately a 70% increased risk for a complication at 90 days — particularly infection and revision,” Bheeshma Ravi, MD, said at the American Academy of Orthopaedic Surgeons Annual Meeting. “Similarly, at 1 year, they had about a 70% increase, again infection and revision. Both, I might add, might be related to technical factors at the time of surgery.”

Bheeshma Ravi

Ravi and colleagues performed a population-based, retrospective, matched-cohort study that looked at health administrative databases. They identified 39,393 eligible hip fracture surgeries, of which 1,085 surgeries were performed concurrently, which meant when they were performed overlapped with another orthopedic case the same attending surgeon was performing.

Investigators then matched 996 of the hip fracture surgeries performed concurrently with 996 hip fracture surgeries performed non-concurrently and compared the groups’ surgical complications at 90 days and 1 year postoperatively.

In addition, Ravi and colleagues performed a secondary regression analysis to determine the effect of overlap on complication rates in concurrent surgeries.

Results at 90 days and 1 year showed there was an increased risk of complications among the patients who underwent concurrent surgery. The risk of complications increased with the increasing duration of overlap. For example, there was about an 8% increased risk for a complication with every additional 10 minutes of overlap in surgical cases, Ravi said. – by Monica Jaramillo

Reference:

Huang A, et al. Paper #123. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 14-18, 2017; San Diego.

Disclosure: Ravi reports no relevant financial disclosures.