Twice the risk of inpatient complications seen after second hip fractures
Key takeaways:
- Patients who had a second, contralateral hip fracture had more major complications.
- The average time of the second hip fracture was 550 days.
SAN DIEGO — Patients have twice the risk of inpatient complications after having a second, contralateral hip fracture within 5 years of their first hip fracture, according to recently presented data.
“When those patients come in, they are sicker. They have developed more comorbidities, and their ambulatory status has decreased significantly,” Sanjit R. Konda, MD, of NYU Langone Orthopedics, told Healio.
The study results were presented at the American Academy of Orthopaedic Surgeons Annual Meeting, here.
In a retrospective review, Konda and colleagues studied results for 3,000 patients who had hip fractures operatively treated between November 2014 and May 2023. Patients were aged older than 65 years, with factures classified as OTA 31A/B, and were studied on the order of their hip fractures, as well as surgical history, demographics, injury characteristics, postoperative complications, 90-day readmission rates, discharge location and direct inpatient hospitalization costs.
Researchers identified 78 patients who were hospitalized after sustaining a second, contralateral hip fracture within 5 years of a first hip fracture. The average time of the second hip fracture was 550 days, and mean patient age was 84.2 years.
Konda and colleagues found patients with a second hip fracture had more major complications (21%) compared with patients who had one hip fracture (10%, P = 0.05). Additionally, patients in the second hip fracture cohort had more minor complications (58%) compared with patients in the first hip fracture cohort (44%, P = 0.08).
“What we’re finding is during their hospitalization, those patients have twice the rate of inpatient complications. That’s a huge finding. When patients come in for their first hip fracture, they’re already at high risk for having a complication. The complications can range – from developing a pneumonia, because they’re being recumbent and lying in bed for too long, or they can develop bedsores, blood clots [or] infections. If they were to develop a second hip fracture, the rate of those complications increases twofold,” Kondas said.
Researchers found no other differences in outcomes and hospitalization cost.
Konda said for a subset of patients during their second hip fracture hospitalization, the rate of complications doubled, but the overall hospital cost for taking care of the patient stayed the same. He said the result speaks to having dedicated and well-established hip fracture pathways within the hospital, which are designed to improve the quality of care and overall value of the care episode for patients.
“We should also keep in mind that, as surgeons, we may have the ability to intervene in a more aggressive manner, but safely and efficiently, on those really high-risk patients to prevent the second hip fracture by considering prophylactic fixation,” Konda said.
For more information:
Sanjit R. Konda, MD, can be reached by email at sanjit.konda@nyulangone.org.
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Herbosa C, et al. Paper 195. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.
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