09.24.15
Hip fracture surgery carries a greater risk of death than elective total hip replacement, according to a study that adjusted for age, sex and co-morbidities.
Researchers from the United Kingdom, Canada and France included 690,995 patients from the French National Hospital Discharge Database -- 371,191 of whom underwent elective total hip replacement (THR) and 319,804 of whom underwent hip fracture surgery at 864 French hospitals between January 2010 and December 2013. The clinicians collected data on patient age and sex, primary diagnosis, procedures performed during hospital stay, length of stay (LOS), in-house complications and mortality.
Researchers also used the International Statistical Classification of Diseases and related Health Problems, 10th Revision codes to determine patients’ comorbidities and postoperative complications. Then, a multivariable logistic model was used to create a matched population of patients who underwent either elective THIR or hip fracture surgery.
The matched population analysis showed patients who underwent elective THR were younger and had less postoperative comorbidities. Patients who underwent hip fracture surgery had a longer mean LOS. Patients were discharged to their home less frequently following hip fracture surgery and were more likely to be readmitted to the hospital after 72 hours compared with patients who underwent elective THR. In-hospital mortality during a readmission was greater in patients who underwent hip fracture surgery compared with patients who underwent elective THR, the findings showed.
“Patients undergoing surgery for a hip fracture were older and had more comorbidities than patients who underwent elective THR, and these differences accounted for some of the difference in outcomes between these groups,” the authors wrote. “Further studies are needed to define the causes for these differences.”
Researchers also used the International Statistical Classification of Diseases and related Health Problems, 10th Revision codes to determine patients’ comorbidities and postoperative complications. Then, a multivariable logistic model was used to create a matched population of patients who underwent either elective THIR or hip fracture surgery.
“Patients undergoing surgery for a hip fracture were older and had more comorbidities than patients who underwent elective THR, and these differences accounted for some of the difference in outcomes between these groups,” the authors wrote. “Further studies are needed to define the causes for these differences.”