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Periprosthetic proximal femoral fractures linked with lower mortality risk long term vs native hip fractures
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A similar mortality risk was seen between patients who had periprosthetic proximal femoral fractures and those who had native hip fractures in the acute phase, according to recently published results. However, lower mortality rates in the long term were seen for patients who had periprosthetic proximal femoral fractures compared with those who had native hip fractures.
“Hip fractures have a well-known association with mortality among geriatric patients,” Mathew R. Boylan, told Healio.com/Orthopedics. “Our study found that periprosthetic hip fractures, specifically periprosthetic proximal femur fractures, however, have a 1-year mortality risk that is significantly lower than that of a native hip fracture.”
He added, “While our analysis was controlled for risk factors including age and comorbid medical conditions, we suspect that the subset of patients with periprosthetic hip fractures are less frail than comparable patients with native hip fractures, with an increased physiologic reserve to tolerate the stresses of trauma, surgery and postoperative rehabilitation. Ultimately, this data can be used by orthopedic surgeons for risk-stratification and counseling of their patients with periprosthetic hip fractures.”
Researchers used the New York Statewide Planning and Research Cooperative System to identify 1,655 patients who were admitted to a hospital from 2006 to 2014 with periprosthetic proximal femoral fractures and 97,231 patients with native hip fractures. Mortality at 1 month, 6 months and 1 year was compared between patients who had periprosthetic fractures and those who had native fractures with mixed-effects regression models.
At 1 month after injury, results showed patients with a periprosthetic proximal femoral fracture did not have a different mortality risk compared with patients who had native hip fractures. However, the mortality risk was lower at 6 months and 1 year in patients who sustained a periprosthetic proximal femoral fracture. Investigators noted advanced age, male sex and higher Deyo comorbidity scores were among the factors correlated with a significantly increased mortality risk in patients with periprosthetic proximal femoral fractures at 1 year. – by Monica Jaramillo
Disclosures: Boylan reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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