Do Mortality and Complication Rates Differ Between Periprosthetic and Native Hip Fractures?

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Epidemiology

Background:

• Rising incidence of periprosthetic hip fractures noted.
• Native hip fractures are well-researched with improving outcomes.
• Limited research exists on periprosthetic hip fracture morbidity and mortality.

Purpose of the Study:

• To compare the morbidity and mortality rates of periprosthetic hip fractures versus native hip fractures.
• To identify independent risk factors for mortality following periprosthetic fractures.

Main Methods:

• Utilized the National Surgical Quality Improvement Program (NSQIP) database.
• Matched 523 periprosthetic hip fractures with native hip fractures using propensity scores.
• Compared 30-day complication rates and used multivariate regression for risk factor analysis.

Main Results:

• Mortality rates were similar between periprosthetic (2.7%) and native (3.4%) hip fractures (P = .49).
• Periprosthetic fractures showed significantly higher overall (63.1% vs 38.6%) and minor complication rates (59.1% vs 34.4%).
• Increased rates of return to OR (7.8% vs 3.1%) and blood transfusion were observed in the periprosthetic group.

Conclusions:

• Periprosthetic hip fractures present similar mortality but significantly higher short-term morbidity compared to native fractures.
• Advanced age (>85) and dependent functional status are independent risk factors for mortality.
• Further research is needed for risk factor identification and prevention strategies for periprosthetic fractures.